Six months after Congress voted for site-neutral Medicare payments, lawmakers appear ready to carve out loopholes.
The policy, backed by the Medicare Payment Advisory Commission, means that Medicare will treat hospitals' off-campus outpatient facilities in the same way as similar facilities that aren't owned by hospitals.
Hospitals argue their higher pay helps them afford to keep their emergency departments and inpatient facilities running 24/7. A bipartisan group of U.S. senators is pressing the CMS to be flexible as it implements the policy, which will apply to facilities built or acquired after Dec. 31.
In a letter last week to the CMS, the senators said the agency should make sure its interpretation of the law will “enable hospitals to continue to serve patients in these settings, as well as provide predictability for the hospital field.” They asked, for example, that site-neutral rates not be triggered when existing hospital outpatient departments expand, relocate or change ownership.
The House Ways and Means Committee, meanwhile, is scheduled to take up legislation this week that would create an exception for hospital-owned outpatient facilities that were under construction when the law was enacted last November.
That bill would also exclude off-campus cancer hospitals. Site-neutral pay is opposed by the Alliance of Dedicated Cancer Centers, which represents the nation's biggest names in cancer care, including Memorial Sloan Kettering Cancer Center in New York City.
The Alliance of Community Oncologists, however, has urged lawmakers not to make exceptions for cancer hospitals, arguing that cancer care consolidation into hospital-owned facilities is raising costs for patients and Medicare.