Statement on Final CY 2019 OPPS Rule

Tom Nickels
Executive Vice President
American Hospital Association

November 2, 2018

Today’s misguided final rule will have negative consequences for the patients we serve. This rule, which phases in over two years payment cuts to hospital outpatient clinic visits, is based on unsupportable analyses and erroneous policy rationales. These ill-advised cuts will hit patients in rural and vulnerable communities especially hard.

Congress recognized the crucial role of hospital outpatient departments in the communities they serve and, in 2015, specifically protected existing facilities from unwarranted payment reductions. Today’s final rule could stifle hospitals’ ability to modernize care to meet the needs of their patients and communities.

This rule also ignores the real and crucial differences between hospital outpatient departments and other sites of care. According to a study conducted by KNG Health Consulting released in September, 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, hospitals are held to far higher regulatory standards because of the complexity of caring for sicker patients.

This new rule compounds the losses the administration has imposed on hospitals serving vulnerable communities by extending the nearly 30 percent cuts in payment for 340B drugs to even more sites of care. 

These actions clearly exceed the administration’s legal authority. The AHA, joined by the AAMC and member hospitals, intends to promptly bring a court challenge to the new rule’s site-neutral provisions. The AHA, along with other hospital associations and member hospitals, is already challenging the 340B policy included in the current outpatient rule.

About the American Hospital Association
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks and other providers of care. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit https://www.aha.org. 

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Contact:       

Marie Johnson, (202) 626-2351

Colin Milligan, (202) 638-5491