News | Published: Wednesday, July 7, 2021 4:00 pm
The Supreme Court has declined to hear an appeal from the American Hospital Association (AHA) and other hospital groups challenging the U.S. Department of Health and Human Services' site-neutral payment policy for hospital outpatient visits. The decision allows the continuation of Medicare payment cuts to off-campus hospital-based clinics.
The policy, issued in 2018, requires hospital outpatient off-campus departments to receive the same reimbursements as independent physician offices for hospital outpatient visit services given to Medicare patients. AHA and other groups filed the lawsuit arguing the rule will harm access to care for hospital outpatients. The court is still reviewing a separate case that challenges a policy where Medicare cut reimbursements by almost 30% to hospitals that receive drug manufacturer discounts through a federal program, 340B.
The push for site neutrality has been a long-standing issue as patients and payers look for health care savings. Some have argued the regulations could threaten access to ambulatory outpatient care, particularly in rural and vulnerable communities. Reductions in outpatient department revenue may lead to increases in other hospital-based services. However, from the patient and physician practice perspective, patients could receive less expensive, same quality services in diverse settings.
To further its commitment and address responsibility for increasing access and value, the ACC, under the guidance of the Health Affairs Committee, has put forth principles pertaining to site neutral payments within Medicare:
For more information, check out a Cardiology article on site neutrality and the CV service line.