Executive Vice President
American Hospital Association
November 2, 2021
Today’s final Medicare outpatient rule contains a number of important policies that will help hospitals and health systems better provide care. We are pleased that CMS recognized the unique role that hospital outpatient departments play in caring for patients by rolling back two problematic policies it put forth last year. Reinstating the list of services that Medicare will pay for only when performed in an inpatient setting due to their medical complexity, and reinstating long-standing safety criteria for allowing procedures to take place in ambulatory surgical centers, is a win for patients’ safety, health and quality of care.
However, we remain disappointed that CMS will continue deep payment cuts to 340B hospitals, which threatens their ability to care for their patients and communities and goes against Congress’ intent in establishing the 340B program nearly 30 years ago. These cuts are enabled by a lower court’s deference to the government’s inaccurate interpretation of the law, which is at the center of the legal issue the Supreme Court will review later this month at our urging. Continuation of these cuts will undoubtedly exacerbate the strain on 340B hospitals, especially as the COVID-19 pandemic continues.
In addition, hospitals and health systems are deeply committed to helping patients access the information they need to make informed decisions about their care, including financial information. That said, we are very concerned about the significant increase in penalties for non-compliance with the hospital price transparency rule, particularly in light of the many demands placed on hospitals over the past 18 months, including both responding to COVID-19, as well as preparing to implement additional, overlapping price transparency policies.
Finally, the AHA applauds today’s 2022 Physician Fee Schedule final rule for delaying the enforcement of the Appropriate Use Criteria program as well as expanding access to telehealth services, especially for behavioral health services.