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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

Published September 28, 2018