Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 10.6.2
Payment Adjustment for Failure to Meet the Hospital
10.6.2 - Payment Adjustment for Failure to Meet the Hospital
Outpatient Quality Reporting Requirements
(Rev. 1657, Issued: 12-31-08, Effective: 01-01-09, Implementation: 01-05-09)
Effective for services furnished on or after January 1, 2009, Section 1833(t)(17)(A) of the
Act requires that “Subsection (d) hospitals” that have failed to meet the specified hospital
outpatient quality reporting requirements for the relevant calendar year will receive
payment under the OPPS that reflects a 2 percentage point reduction of the annual OPPS
update factor. See www.qualitynet.org for information on complying with the reporting
requirements and standards that must be met to receive the full update.