AHA urges CMS to delay implementing site-neutral proposal due to fraud and abuse risks

Implementing the site-neutral provisions of the Bipartisan Budget Act on Jan. 1 would raise significant compliance risks under the Stark law and the Anti-kickback statute, AHA told the Centers for Medicare & Medicaid Services today, citing a legal analysis of the agency’s proposal by Hogan Lovells. “Because CMS cannot finalize its proposal without forcing impacted hospitals to accept significant compliance risk, it must delay the implementation of the site-neutral policies in the proposed rule by at least one year,” wrote AHA Executive Vice President Tom Nickels. “This delay would provide the time necessary for CMS to develop a fair and flexible payment policy under which hospitals would be able to receive direct payment for their non-excepted [hospital outpatient departments] and for non-excepted items and services that they furnish in excepted HOPDs.” The site-neutral proposal was included in the outpatient prospective payment system proposed rule for calendar year 2017. AHA plans to submit detailed comments on the rule’s site-neutral and other proposals in a separate letter to the agency.