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For purposes of section 1833(t)(3)(C)(iv) of the Act, subject to sections 1833(t)(17) and 1833(t)(3)(F) of the Act, the OPD fee schedule increase factor is equal to the hospital inpatient market basket percentage increase applicable to hospital discharges of the Act (or an amount that is computed and applied with respect to covered OPD services)

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One commenter suggested that Safety of Care measures may not sufficiently account for clinical complexity, particularly for large tertiary hospitals and those performing high volumes of complex cases, which could obscure meaningful quality differences and discourage hospitals from treating high-risk patients

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