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September 28, 2018 News Headlines

HANYS Urges CMS to Rescind Medicare Site-Neutral Payment Cuts

This week, HANYS sent a letter urging CMS to rescind its proposal to implement drastic site-neutral payment reductions to off-campus, provider-based departments (PBDs) which were designated “excepted” or grandfathered under the Bipartisan Budget Act (BBA) of 2015.  CMS’ proposal, issued as part of the Medicare outpatient payment rule for 2019, would cut outpatient payment by 60 percent to all off-campus provider-based departments for a basic clinic visit regardless of “excepted” or “non-excepted” status initiated by Section 603 of BBA. 

Basic clinic visits represent a large share of services provided at off-campus PBDs.  HANYS strongly opposed CMS’ proposal, citing the financial and access implications of the proposed policy as well as the agency’s dismissal of congressional intent around the site-neutral payment issue.  Overall, the policy would cut Medicare fee-for-service funding to hospitals and health systems in New York by $41 million in just one year; $760 million nationally.  Factoring in the effect of this policy on services to Medicare Advantage patients, New York State’s impact grows from $41 million to more than $70 million in the first year and would total more than $785 million across the next decade.   HANYS also commented on other aspects of the proposed rule, including changes to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and issued opinions on price transparency and ways to promote interoperability. Contact: Melanie Graham


House and Senate Agree on Opioid Crisis Response Act

After weeks of negotiations, the both houses of Congress released compromise legislation to address the opioid epidemic.  The Opioid Crisis Response Act (H.R. 6) passed the house on Friday by a 393 to 8 vote.  The Senate is expected to pass the bill in early October.  The legislation includes HANYS-supported provisions that would allow states to receive federal Medicaid matching funds for up to 30 days per year for services at an institution for mental disease provided to adults between 21-64 years for substance use disorders.  It also includes access to telehealth and medication-assisted treatment, a need that HANYS’ members have highlighted.  The bill includes alternatives to opioids for pain management, and abuse deterrence and prevention provisions.  Notably, the bill does not include language that would align 42 Code of Federal Regulations (CFR) Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA) as advocated by HANYS. 

Meanwhile, Congress cleared and the President has signed into law a spending package to fund the federal government and avert a partial government shutdown.  The package funds certain agencies through Dec. 7, and a one year deal on the Labor, Health and Human Services and Defense Appropriations bills.   The bi-partisan deal increases funding for the Department of Health and Human Services by 2 percent over fiscal year 2018 levels.  It also includes $6.7 billion in funding for programs addressing the opioid epidemic and access to mental health services. These resources include increased funding for the Substance Abuse and Mental Health Services Administration, National Institutes of Health, and Centers for Disease Control and Prevention.  The President has indicated he will sign the bill before the Sept. 30 deadline. Contact: Cristina Batt