News & Updates

July 26, 2023

Alliance Applauds House Ways and Means Committee Work on Site Neutral Policies, Urges Further Action

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 commended the House Ways and Means Committee for its passage of legislation to require site neutral payments for Medicare Part B drug administration services. The Committee’s markup demonstrates progress towards improving competition and lowering costs in our health care system, but more must be done to address the growing trend of hospital acquisition of independent physician practices.

The Alliance applauds the inclusion of site neutral payments for drug administration in H.R. 4822, the Health Care Price Transparency Act, but strongly recommends that any site neutral policy that comes to the House floor apply equally to all off-campus hospital outpatient departments (HOPDs). Widespread implementation of site neutral payments is critical to stemming the tide of consolidation and ensuring all patients benefit from lower costs. The Alliances notes that the provision requiring site neutral payments for drug administration services in H.R. 3561, the PATIENT Act, would apply evenly to all off-campus HOPDs.

Further, the Alliance encourages the Committee to pass comprehensive legislation that removes the grandfathering exceptions in the 2015 Bipartisan Budget Act entirely and implements site neutral payments across the board. The Alliance has long advocated that patients and Medicare should pay the same amount for the same service regardless of where that service is provided.

Congress took an important first step 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 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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