News & Updates

November 29, 2016

Congress Should Scrap Some Medicare Pay Changes in Cures Bill, Group Says – Bloomberg BNA, Nov. 28, 2016

By Michael D. Williamson | November 28, 2016 3:34PM ET

Nov. 28 (BNA) – Congress should keep a Medicare site-neutral payment policy for certain hospital outpatient departments, a coalition representing insurers, providers, patient advocates and employers said today.

Congress should remove provisions in the 21st Century Cures legislative package that would exempt cancer hospitals and certain hospital outpatient departments from site-neutral payment policies signed into law as part of the Bipartisan Budget Act of 2015, the Alliance for Site Neutral Payment Reform said in a letter to the Republican and Democratic leaders of the House Energy and Commerce Committee. Members of the alliance include the Blue Cross and Blue Shield Association, an insurer; the American Health Care Association, a nursing home trade group; and the National Restaurant Association, an employer organization for eatery owners.

Site-neutral payments are set to take effect Jan. 1, 2017, and they mean certain items and services provided by some off-campus outpatient departments will no longer be paid under the hospital outpatient prospective payment system, which has higher reimbursement rates than the Medicare physician fee schedule. Hospitals have long been encouraged by the outpatient payment system’s higher rates to acquire physician offices in order to receive the higher rate.

The House is expected to vote on revised Cures legislation on Wednesday, and a version of the legislation released Nov. 25 includes provisions that would change which hospital outpatient departments would be subject to site-neutral payments.