News & Updates

May 17, 2023

Alliance Urges House Energy and Commerce Subcommittee on Health to Address Grandfathered HOPDs

WASHINGTON – The Alliance for Site Neutral Payment Reform – a coalition of patient advocates, providers, payers, and employers dedicated to advancing site neutral payment policies to equalize payments across sites of service for all outpatient services – today applauded the House Energy and Commerce Subcommittee for its continued focus on the problem of health care consolidation. The Committee’s markup today demonstrates considerable progress towards ensuring transparency and competition in our health care system, but more must be done to address the growing trend of hospital acquisition of independent physician practices.

Congress took critical action to address this widespread issue with the passage of the Bipartisan Budget Act (BBA) of 2015, yet it is clear that the goals of that legislation have not yet been achieved. Under the 2015 law, the vast majority of hospital outpatient departments (HOPDs) were grandfathered under the old, higher payment rates. As a result, Medicare continues to reimburse HOPDs at much higher rates than physician offices for the exact same services and the incentive for hospital acquisition of physician practices remains.

The Alliance commends the inclusion of site neutral payments for drug administration in H.R. 3281, the Transparent PRICE Act, as a meaningful first step. In addition to this amendment, the Alliance urges the Committee to move forward with comprehensive legislation that removes the grandfathering exceptions from the 2015 BBA and implements site neutral payments more broadly.

The Alliance strongly urges lawmakers to continue working towards a healthcare landscape that fosters equitable reimbursement for all providers. The Alliance for Site Neutral Payment Reform stands ready to work alongside the Committee and other policymakers to implement legislation that promotes fair competition, patient choice, and a more cost-effective healthcare system.




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