Site-neutral payment rule sparks sharp rebuke from American Hospital Association and threat of legal action
The AHA said the policy exceeds the administration's legal authority and, joined by the AAMC and member hospitals, intends to legally challenge it.
Calling the policy misguided and based on "unsupportable analyses and erroneous policy rationales," the American Hospital Association is firing back at the Centers for Medicare and Medicaid Services over the recently finalized outpatient prospective payment system, which seeks to equalize what physician offices and hospital outpatient departments are paid for certain clinical visits, a change that will be phased in over two years.
The AHA said the policy exceeds the administration's legal authority and, joined by the AAMC and member hospitals, intends to legally challenge it. The AHA and other hospital associations are already challenging the 340B policy included in the current outpatient rule.
WHY IT MATTERS
The AHA said the OPPS final rule, which will phase in payment cuts to hospital outpatient clinic visits, will have "negative consequences" for patients, with those in rural and vulnerable communities getting hit especially hard.
THE TREND
The new rule makes cuts payments for hospital outpatient clinic visits at off-campus provider- based facilities in order to level them out against what is paid to physician offices. Half of the total reduction will take effect in 2019.
CMS is also expanding its 340B policy by including additional off-campus provider-based hospital outpatient departments that are paid under the physician fee schedule in the payment change.
ON THE RECORD
"Congress recognized the crucial role of hospital outpatient departments in the communities they serve and, in 2015, specifically protected existing facilities from unwarranted payment reductions. Today's final rule could stifle hospitals' ability to modernize care to meet the needs of their patients and communities...This new rule compounds the losses the administration has imposed on hospitals serving vulnerable communities by extending the nearly 30 percent cuts in payment for 340B drugs to even more sites of care. " said Tom Nickels, AHA executive vice president.
Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com
