The Provider Roundtable (2003-2023) was created to give hospital professionals a forum to communicate effectively with CMS on critical health care regulation issues. The PRT’s advocacy and information to CMS resulted in many Medicare payment system changes, most notably within the Outpatient Prospective Payment System / Ambulatory Surgery Center Payment System (OPPS/ASC).
What is the Provider Roundtable?
The Provider Roundtable (PRT) brought together a group of hospital representatives from around the country who are experienced in managing under OPPS/APCs, IPPS/MS-DRGs, and the MPFS. Formed in 2003 by Nimitt Consulting in partnership with 3M Health Information Systems (3M HIS) and HCPro, Inc, the professionals on the PRT dealt with Medicare regulations on a daily basis and had important information to communicate with CMS about the impact of Federal regulations on operations and finances.
The PRT provided a unique opportunity for peers from around the country to provide feedback on the impact of health policy and payment system changes on hospital operations.
Nimitt believes that the voices of front-line professionals dealing with Medicare rules and regulations should be the most significant when CMS is considering changes to its payment systems.
The PRT provided input to CMS on health care policy and regulatory changes, including coding, billing, coverage, and reimbursement issues.
Who Served on the Provider Roundtable?
PRT members were employed by a hospital or health system and came from health information management, finance, the business office, patient accounting, clinical and ancillary departments, and information systems. The PRT met throughout the year to develop detailed comments on numerous issues raised in CMS’ proposed rules. The PRT also routinely provided oral testimony to the HOP Panel (formerly the APC Advisory Panel). PRT members have presented on issues including the separately payable observation APC, packaging, packaged revenue codes, the inpatient-only list, drug administration, use of HCPCS codes for evaluation and management services, appropriate rate-setting for combinations of CPT codes, and much more.
The PRT was successful in communicating with CMS, the HOP Panel, the American Hospital Association, and other industry organizations and associations. Many of the PRT’s concerns have been heard over the years and their recommendations implemented.
Provider Roundtable’s Advocacy
To read more about the Provider Roundtable’s comment letters on CMS rules, see below.
- Provider Roundtable Comments on the CY 2022 Outpatient Prospective Payment System (OPPS) Proposed Rule PDF Document, 0.8 MB
- Provider Roundtable Comments on the CY 2022 Medicare Physician Fee Schedule (MPFS) Proposed Rule PDF Document, 0.4 MB
- Provider Roundtable Comments on the CY 2021 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule PDF Document, 2 MB
- Provider Roundtable Comments on the CY 2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule PDF Document, 1 MB
- Provider Roundtable Comments on the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule PDF Document, 2 MB
- Provider Roundtable Comments on the CY 2020 Medicare Physician Fee Schedule (MPFS) Proposed Rule PDF Document, 0.7 MB
- Provider Roundtable Comments on the Specialty Care Models to Improve Quality of Care and Reduce Expenditures Proposed Rule PDF Document, 2 MB
- Provider Roundtable Comments on the CY 2019 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule PDF Document, 2 MB
- Provider Roundtable Comments on the CY 2019 Medicare Physician Fee Schedule (MPFS) Proposed Rule PDF Document, 1 MB
- Provider Roundtable Comments on the FY 2019 Inpatient Prospective Payment System (IPPS) Proposed Rule PDF Document, 0.5 MB
- Provider Roundtable Submissions to the Committee on Ways and Means, Subcommittee on Health for the “Medicare Red Tape Relief Project” PDF Document, 0.16 MB
- Provider Roundtable Comments on the CY 2018 MPFS Proposed Rules PDF Document, 2 MB
- Provider Roundtable Comments on the CY 2018 OPPS Proposed Rules PDF Document, 2 MB