The CMS Thursday said it will pay hospitals the money it owes them for doctor's visits in 2019.
A federal judge ruled in September that the Trump administration had exceeded its authority when it implemented its so-called site-neutral payment policy at off-campus hospital clinics. The American Hospital Association, which filed the lawsuit, estimated that the policy cost providers about $380 million in 2019. U.S. District Judge Rosemary Collyer in Washington, D.C., did not require the CMS to repay the funds at the time, instead asking the AHA and the CMS to file a joint status report. The CMS' decision is a big win for hospitals.
Nonetheless, HHS is appealing the September ruling, according to a notice of appeal filed Thursday. The CMS also is also moving forward with its site-neutral payment policy in 2020, which was included in the final Outpatient Prospective Payment System rule in November, an agency spokesperson confirmed. Hospitals had estimated that they would lose $760 million in 2020 if the policy goes into effect.
"This policy was adopted as a method to control unnecessary increases in the volume of clinic visit services furnished in off-campus provider-based departments paid under the (Outpatient Prospective Payment System) and will help reduce out of pocket costs for Medicare beneficiaries," said a CMS spokesperson
The AHA recently asked a federal court to block implementation of the site-neutral policy for 2020, arguing that the payment cuts are illegal because it's the same policy Collyer threw out early this fall.
