AHA, AAMC sue HHS over outpatient payment policy

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.