Congress is considering several proposals that would impose additional Medicare site-neutral payment reductions for services provided in hospital outpatient departments (HOPDs).
Site-Neutral Payment Proposals Fact Sheets
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Legislative efforts to enact a Medicare Payment Advisory Commission (MedPAC) proposal that would impose site-neutral payment cuts on hospitals for certain outpatient services — including those occurring in both on-campus and off-campus hospital outpatient departments (HOPDs) — would lead to significant and unacceptable Medicare cuts for hospitals and health systems, jeopardizing access to hospital care for millions of Americans.
Facility fees are the portion of a health care treatment bill that covers all the costs of delivering patient care, except for those that are billed by physicians and other professionals.
The AHA strongly opposes site-neutral payment cuts, which would reduce access to critical health care services, especially in rural and other underserved communities.
NEW: National and State Impacts of Site-neutral Provisions in the Lower Costs, More Transparency Act (H.R. 5378
Congress is considering several bills that would impose additional site-neutral payment reductions for services provided in hospital outpatient departments (HOPDs). A description of these bills, AHA’s take on the proposals and the potential impact these proposals would have on Medicare reimbursement to hospitals and health systems follow.
The AHA strongly opposes policies to decrease hospital reimbursements by eliminating “facility fees,” which are the direct and indirect costs that allow a hospital to continue to provide services to patients and serve the needs of their community.
Policymakers and others have expressed growing concern about the trend of physician practices becoming affiliated with hospitals and health systems.
Congress is considering several bills that would impose additional site-neutral payment reductions to services provided in hospital outpatient departments (HOPDs).
Section 603 of the Bipartisan Budget Act of 2015 requires that, with the exception of emergency
Fact Sheet: Changes to Site-neutral Payment Provisions in CMS's Physician Fee Schedule Proposed Rule
Section 603 of the Bipartisan Budget Act of 2015 (BiBA) requires that, with the exception of emergency department (ED) services,1 services furnished in off-campus provider-based departments (PBDs) that began billing under the outpatient prospective payment system (OPPS) on or after Nov. 2, 2015 (referred to as "non excepted services") are no longer paid under the OPPS.