AHA Statement on Final CY 2020 OPPS Rule

Tom Nickels
Executive Vice President
American Hospital Association

November 1, 2019

Today’s final rule from CMS regrettably ignores recent legal decisions while also putting even more pressure on hospitals and health systems that care for vulnerable patients and communities.

The final rule’s continued payment cuts for hospital outpatient clinic visits not only threatens access to care, especially in rural and other vulnerable communities, but it goes against clear congressional intent to protect the majority of clinic services. There are many real and crucial differences between hospital outpatient departments and the patient populations they serve and other sites of care. Now that a federal court has sided with the AHA and found that these cuts exceed the Administration’s authority, CMS should abandon further illegal cuts. Instead, as we urged in a letter to the Department of Justice yesterday, CMS should promptly repay the affected hospitals the full OPPS rate to support the work they do for the patients they serve. And CMS should pay the full OPPS rate for all clinic visit claims going forward.

Moreover, this rule’s perpetuation of cuts in payments for 340B drugs also defies the judgement of the courts, further straining hospitals serving their communities. After previous cuts to the 340B program were ruled illegal and overturned in court because they exceeded the Administration’s authority, continuation of that policy is wholly unwarranted. CMS should instead offer a plan to swiftly restore in full the funds to those 340B hospitals affected by the illegal cuts so they can continue to care for their patients and communities. This could be done in a non-budget neutral manner, so it does not unfairly penalize other hospitals.



Colin Milligan, (202) 638-5491; cmilligan@aha.org

Marie Johnson, (202) 626-2351; mjohnson@aha.org

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