Hospitals seek to stop January Medicare reimbursement cuts to off-site clinics

The American Hospital Association said it will seek enforcement of a Sept. 17 federal court decision that would stop cuts to  Medicare reimbursement rates for off-site clinics. 

Along with the Association of American Medical Colleges and several U.S. hospitals, the hospital association plans said it will  immediately request that the Washington, D.C., federal court enforce the ruling that CMS overstepped its statutory authority in 2018 when it expanded a site-neutral pay policy that cut the reimbursement rate for evaluation and management services provided at off-campus provider-based departments. 

The 60 percent Medicare payment cuts for hospital outpatient visits were made under the 2019 Medicare Outpatient Prospective Payment System final rule, with a two-year phase-in for this policy.

On Nov. 1, CMS announced it will finish phasing in the policy, even after U.S. District Judge Rosemary M. Collyer ruled Sept. 17 in favor of the American Hospital Association and backed that decision in an October ruling. 

In a notice filed on Nov. 6, the American Hospital Association and other plaintiffs said the CMS decision to finish phasing in the cuts under the 2020 Medicare Outpatient Prospective Payment System final rule is improper. 

This "violates both this court's substantive ruling and its order denying the government's motion for reconsideration," the plaintiffs wrote. 

The plaintiffs requested issuance of a briefing schedule to permit resolution of their motion to enforce the September ruling as soon as possible — before the 2020 Medicare Outpatient Prospective Payment System final rule takes effect in January.

 

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