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Home E-Weekly July 25, 2017

CMS Looks to Slash Payment for Off-campus Services by Half

Published: July 24, 2017

SITE SPECIFIC CMS wants to slash payments for off-campus hospital outpatient services by another 25%.

For the second straight year, CMS wants to cut by half what Medicare pays for services provided at medical facilities that are owned by hospitals but located off their campuses — from 50% of the outpatient prospective payment system for 2017 to 25% of OPPS rates for most services in 2018.

The proposed plan would affect such services as pain management, some X-rays, radiation therapies and some behavioral health services.

"CMS believes that this adjustment will encourage fairer competition between hospitals and physician practices by promoting greater payment alignment," the agency said.

Hospitals groups strongly oppose the proposed rule, saying the proposed Medicare reimbursement cuts would decrease patient access to care at the facilities, especially in underserved areas.

"This proposal appears to have a questionable policy basis and is yet another blow to access to care for patients, including many in vulnerable communities without other sources of health care," says Tom Nickels, executive vice president of the American Hospital Association.

Bruce Siegel, MD, MPH, president and CEO of America's Essential Hospitals, says the proposal would disincentive hospitals from opening or operating new off-campus provider-based locations.

"Hospitals that otherwise would seek to enhance access by establishing clinics in healthcare deserts will not do so if they determine this damaging payment policy makes new outpatient centers economically unsustainable," says Dr. Siegel.

Comments on the proposed rule change are due by Sept. 11.

Daniel Cook

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