The Panel shall consist of up to 15 members who are full-time employees of hospitals and other Medicare providers subject to the Outpatient Prospective Payment System (OPPS).  The Secretary or Administrator (CMS) selects the Panel membership based upon either self-nominations or nominations submitted by Medicare providers and other interested organizations.

All members must have technical expertise that shall enable them to participate fully in the work of the Panel.  Such expertise encompasses hospital payment systems, hospital medical-care delivery systems, outpatient payment requirements, APCs, Current Procedural Terminology codes, and the use/payment of drugs and medical devices in the outpatient setting—as well as other forms of relevant expertise.  However, it is not necessary that any member be an expert in all of the areas listed above. 

The Panel members shall have a minimum of 5 years experience in their areas of expertise, and they must be currently employed full-time in their areas of expertise.  For purposes of this Panel, consultants and independent contractors are not considered to be full-time employees.  A Federal official shall serve as the Chair; s/he shall call and facilitate the Panel meetings.  A Designated Federal Officer (DFO) shall be appointed to the Panel who maintains required records on costs, meetings, day-to-day operations, and membership; ensures efficient, ethical operations; and provides management support services for the Panel and its standing and ad hoc subcommittees.

Meetings shall be held up to three times a year at the call of the Chair.  The agenda, which will set the boundaries for discussion, shall be developed by CMS, specifically by the Chair, the DFO, and other OPPS staff.  The Panel is technical in nature and shall deal with the following issues:  addressing whether procedures are similar both clinically and in terms of resource use; reconfiguring APCs (for example, splitting of APCs, moving Healthcare Common Procedure Coding System (HCPCS) codes from one APC to another, and moving HCPCS codes from new technology APCs to clinical APCs); evaluating APC weights; packaging device and drug costs into APCs:  methodology, effect on APCs, and need for reconfiguring APCs based upon device and drug packaging; removing procedures from the inpatient list for payment under the OPPS; using single and multiple procedure claims data; packaging of HCPCS codes; and addressing other technical issues concerning APC structure.

All members shall serve in a voluntary status without compensation pursuant to advance written agreement.  Members of the Panel shall be entitled to receive reimbursement for travel expenses and per diem in lieu of subsistence, in accordance with Standard Government Travel Regulations.

Downloads
August 27-29, 2008 Agenda, Recommendations, and Report [PDF, 79 KB] - Updated 09/16/08 CMS-1394-N [PDF, 147KB] March 5-6, 2008 Agenda, Recommendations, and Report [ZIP, 211KB] CMS-1323-N [PDF, 65KB] March 7-9, 2007 Mtg,Agenda,Rpt  [ZIP 56KB]- Updated 03/22/2007 Charter 2006 [PDF 34KB] - Updated 08/07/2008 Advisory Panel on APC Group Presenter/Presentation Information Checklist (Form CMS-20017) [PDF 26KB]
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