House members urge CMS to reconsider site-neutral payment proposals  

One hundred thirty-eight members of the House of Representatives yesterday expressed concern with the Centers for Medicare & Medicaid Services’ proposal to expand certain site-neutral payment policies to grandfathered off-campus hospital provider-based departments in calendar year 2019. The proposed cuts to hospital outpatient department evaluation and management services and future services from new clinical families “may run contrary to actions by Congress under Section 603 of the Bipartisan Budget Act of 2015,” and “affect efforts to move to value-based care,” the representatives said.  

With respect to Section 603, the representatives said it “is unclear how CMS has deemed all of the OPD services at the grandfathered off-campus HOPDs as cause of an unnecessary increase in volume of OPD services,” noting that the impacted facilities “provide care to some of the most vulnerable patient populations in difficult to serve areas.” Earlier this month, 48 senators urged CMS to reconsider this proposal.