The Medicare Payment Advisory Commission today issued its June report to Congress, which includes the panel’s recent recommendation to reduce emergency department evaluation and management services payment rates by 30% for off-campus stand-alone EDs located within six miles of an on-campus hospital ED. The AHA in March urged MedPAC not to approve the recommendation, saying it was not based on any analysis of Medicare beneficiaries, Medicare costs or Medicare payments and would make Medicare’s record underpayment of outpatient departments and hospitals even worse. Medicare margins were a record-low negative 14.8% for hospital outpatient departments and negative 9.6% for hospitals overall in 2016, with the latter expected to reach negative 11% this year. The report also includes an AHA-supported recommendation to allow isolated rural hospitals located more than 35 miles from another ED to convert to stand-alone EDs that would be able to bill under the outpatient prospective payment system. These EDs also would be provided with annual payments to assist with their fixed costs. In addition, the report includes a mandated report on the Hospital Readmissions Reduction Program and recommends changes related to post-acute care payment, quality reporting programs, accountable care organizations and other areas. Meanwhile, the Medicaid and CHIP Payment and Access Commission today released its June report to Congress, which includes recommendations to change statutory provisions that prevent state Medicaid programs from paying the lowest price for certain drugs and clarify regulations on protecting the privacy of patients with substance use disorder to support integration of care.

Related News Articles

Headline
The House July 3 voted 218-214 to pass the final version of the One Big Beautiful Bill Act (H.R. 1), which enacts many of President Trump’s legislative…
Headline
The U.S. District Court for the Middle District of Tennessee June 30 denied a motion for a preliminary injunction by AbbVie in its lawsuit against the state’s…
Headline
The Senate narrowly passed the One Big Beautiful Bill Act (H.R. 1) on July 1 by a 50-50 tally, with Vice President J.D. Vance casting the tie-breaking vote.…
Headline
The AHA June 29 sent a letter to senators urging them to amend the budget reconciliation bill before its final passage in the Senate. The Senate version of the…
Headline
The AHA June 27 filed an amicus brief in the U.S. District Court for the Middle District of Tennessee that defends the state’s 340B contract pharmacy law…
Headline
The latest video in the AHA’s series “Medicaid: Real Lives, Real Care” features Melissa Fannon-Wisner, DNP, nurse educator and nurse practitioner at Valley…