The AHA, joined by the Association of American Medical Colleges and several member hospitals, today filed a lawsuit against the Department of Health and Human Services for finalizing a policy to phase-in, over two years, a reduction in payments for hospital outpatient clinic visit services furnished in off-campus provider-based departments that are grandfathered (excepted) under Section 603 of the Bipartisan Budget Act of 2015. The cut was included in the Centers for Medicare & Medicaid Services’ outpatient prospective payment system final rule for calendar year 2019, released this month.
 
“These cuts directly undercut the clear intent of Congress to protect hospital outpatient departments because of the real and crucial differences between them and other sites of care,” said AHA President and CEO Rick Pollack. “For example, patients who receive care in a hospital outpatient department are more likely to be poorer and have more severe chronic conditions than patients treated in an independent physician office. In addition, only hospitals provide 24/7 access to care for patients, regardless of their ability to pay, hospitals are held to far higher regulatory requirements, and hospital outpatient departments in inner cities and rural areas are often the only sites of care that provide the services they do.”

Joining the associations in the lawsuit are Olympic Medical Center in Port Angeles, Wash., Mercy Health in Muskegon, Mich., and York Hospital in York, Maine.
 

Related News Articles

Headline
Eligible hospitals can apply through July 6 to participate in the Medicare Direct Contracting Model, which will offer two primary care payment options for…
Headline
The Center for Medicare and Medicaid Innovation today announced several COVID-19-related modifications to current and future CMMI alternative payment models.…
Headline
The Centers for Medicare & Medicaid Services yesterday released a fact sheet for state and local governments seeking Medicare, Medicaid or Children’s…
Headline
Over 1,750 Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs…
Headline
The Government Accountability Office today named three new members to the Medicare Payment Advisory Commission through April 2023. They are: Wayne…
Headline
The Centers for Medicare & Medicaid Services yesterday released early stakeholder insights from its Accountable Health Communities Model. The model tests…