A bipartisan group in the U.S. Senate is asking the CMS to avoid strict interpretations as it implements site-neutral payments for off-campus hospital outpatient departments.
The site-neutral provision was part of a two-year budget deal reached toward the end of last year. It states that off-campus hospital outpatient departments will be paid under Medicare Part B systems instead of outpatient prospective payment systems. It is set to go into effect on Jan. 1 of next year.
In a letter to the CMS, 51 senators led by Sens. Rob Portman (R-Ohio) and Chuck Schumer (D-N.Y.) said they wanted "to underscore the importance of including flexibilities to enable hospitals to continue to serve patients in these settings as well as provide predictability for the hospital field.”
They ask that facilities meeting the definition of dedicated emergency department be exempt from the site-neutral provision for all services, including non-emergency. They also want existing hospital outpatient departments that expand, relocate or have a change in ownership to not trigger the site-neutral rates.
The senators also urge the CMS to use a standard of “reasonable proximity” when determining whether a building is on-campus. The current regulation states buildings must be within 250 yards of the main campus buildings but does not take into account barriers like rivers or highways.
A similar letter has so far garnered more than 200 signatures in the House, according to the American Hospital Association, which has opposed payment parity.
The site-neutral regulations stem from a 2013 Medicare Payment Advisory Commission report that found Medicare paid 141% more for a Level 2 echocargiogram in an outpatient setting as opposed to one performed in physician's office.