House leaders urged to remove certain provisions from price transparency bill

AHA today voiced support for a provision in the Lower Costs, More Transparency Act (H.R. 5378) that would suspend for two years the Medicaid disproportionate share hospital reductions scheduled to go into effect on Oct. 1, but urged House leaders to reject another provision that would permanently implement reductions to Medicare payments for drug administration services in off-campus hospital outpatient departments. 
 
“Existing site-neutral payment cuts have already had a significantly negative impact on the financial sustainability of hospitals and health systems and have contributed to Medicare’s chronic failure to cover the cost of caring for its beneficiaries,” AHA wrote. “This proposal would expand upon these shortfalls, further exacerbating the financial challenges facing many hospitals and threaten patients’ access to quality care.”
 
Among other changes, AHA said the legislation should allow hospitals to continue using price estimator tools to meet the shoppable services requirement as allowed under the Hospital Price Transparency Rule and permit CMS to continue to determine the maximum penalty assessed to noncompliant hospitals, rather than set a maximum amount in statute; and remove unnecessary and burdensome provisions that would establish unique identifiers for off-campus HOPDs and require 340B entities to report the difference between their acquisition cost and payments from Medicaid managed care organizations.