House lawmakers launch effort to block site-neutral payments

Two U.S. House of Representatives lawmakers on Thursday launched a bipartisan effort to override the Trump administration's site-neutral pay regulation.

Rep. Derek Kilmer (D-Wash.) and Rep. Elise Stefanik (R-N.Y.) want to block a final CMS rule that went into effect Jan. 1 and cuts Medicare rates for hospital offsite clinics for some outpatient treatments. Their bill is backed by the American Hospital Association and the Federation of American Hospitals, which represents investor-owned systems, and they are looking for senators to introduce companion legislation in that chamber..

The CMS rule, which has already spurred litigation, is trying to level pay for certain outpatient treatments no matter where they're dispensed, focusing on evaluation and management visits. The agency projected the change will cut $380 million in hospital payments this year.

Erik Rasmussen, AHA's vice president of legislative affairs, said the group wants Congress to include the measure in a budget deal and is "open to working with Congressional leadership on other alternatives."

A spokesperson for Kilmer emphasized the congressman is making it a priority to advance the legislation.

Kilmer worked with House appropriators to make sure the lower chamber's HHS appropriations committee report included a rebuke to the CMS about the rule. The report asked the agency to reconsider its policy, taking a close look at hospitals where there are healthcare shortages.

The lobbying effort also pushed lawmakers to write to HHS Secretary Alex Azar, urging him to reverse the policy.

It's been a tumultuous healthcare policy week in Washington. Hospitals scored a major win when a federal court halted the CMS' Medicare cuts to 340B providers.

U.S. District Court Judge Rudolph Contreras on Monday ordered HHS to try to come up with a financial remedy for the hospitals that saw pay cuts in 2018 and 2019. While the judge said a retroactive fix could cause administrative havoc, his decision gives the agency some "flexibility" to to decide how to move forward.

Redresses on the table could include "possibly making remedial payments in a non-budget neutral manner," Contreras wrote.

He added that the HHS secretary "may be able to raise 340B rates in future years to compensate for the 2018 and 2019 underpayments."