GAO-04-103R  Medicare: Discrepancy in Hospital Outpatient Prospective Payment System Methodology Leads to Inaccurate Beneficiary Copayments and Medicare Payments

October 6, 2003 Medicare: Discrepancy in Hospital Outpatient Prospective Payment System Methodology Leads to Inaccurate Beneficiary Copayments and Medicare Payments When CMS published the final rule updating the OPPS payment rates for 2003, the agency stated that it used the methodology implemented in 2002 for determining 2003 copayments. However, in the course of other ongoing work, we found several APCs for which copayment amounts increased from 2002 to 2003, contrary to the methodology implemented in 2002. For a federal agency to adopt a new position or payment methodology that is inconsistent with existing rules and regulations, it must follow Administrative . . .