Site-Neutral

Jul 12, 2018
The Centers for Medicare & Medicaid Services today proposed to update physician fee schedule rates by 0.25% in calendar year 2019, as required under the Medicare Access and CHIP Reauthorization Act of 2015. After this update and the budget-neutrality adjustment required by law, the proposed…
Jul 13, 2018
The Centers for Medicare & Medicaid Services July 12 issued a proposed rule that would update physician fee schedule payments for calendar year 2019. The rule also included several proposals to implement year three of the quality payment program created by the Medicare Access and CHIP…
Jun 25, 2018
The AHA supports several of the proposed rule’s provisions. In particular, we appreciate and endorse the agency’s proposal to permanently withdraw the 25% Rule; however, we oppose the associated budget neutrality adjustment proposed by CMS. We also support the proposed changes related to co-located satellite facilities, and the streamlining of the LTCH quality reporting program. In addition, this letter reiterates our concerns related to underpayment for site-neutral cases.
Apr 22, 2018
Section 603 of the Bipartisan Budget Act of 2015 requires that, with the exception of emergency department services,1 services furnished in off-campus provider-based departments (PBDs) that began billing under the outpatient prospective payment system on or after Nov. 2, 2015 (referred to as “non-excepted services”) are no longer paid under the OPPS. Instead, these services are covered and paid under “another applicable Part B payment system.”
For calendar year 2017, the Centers for Medicare & Medicaid Services finalized the physician fee schedule as the applicable Part B payment system and set payment for most non-excepted services at 50 percent of the OPPS rate. For CY 2018, CMS further reduced the site-neutral payment rates – to…
Mar 26, 2018
Medicare pays long-term care hospitals less than half the cost of care for site-neutral cases under the LTCH prospective payment system, AHA told the Centers for Medicare & Medicaid Services Friday. “Our analyses show that these substantial underpayments are occurring because, contrary to CMS’s…
Mar 5, 2018
A recent opinion piece in The Hill “gives readers a one-sided, misleading and misinformed view on the issue of site-neutral payment proposals and consolidation in the health field,” writes AHA Executive Vice President Tom Nickels in an op-ed piece published Friday. “To start, the author fails…
Jan 30, 2018
Americans rely heavily on hospitals to provide 24/7 access to care for all types of patients, to serve as a safety net provider for vulnerable populations, and to have the resources needed to respond to disasters. These roles are not explicitly funded; instead they are built into a hospital’s…
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Outpatient PPS

Dec 16, 2017
Outpatient care has become increasingly important, as technological innovations and patient preferences drive changes in care delivery.
Medicare beneficiaries receive a wide range of services in hospital outpatient departments, from injections to complex procedures that require anesthesia. Payment policies for services furnished in hospital outpatient departments are constantly changing due to technological advances and changes in…
Dec 14, 2017
The AHA today urged the Centers for Medicare…