CMS finalizes site-neutral payment rule but, American Hospital Association plans to sue CMS over it

Centers for Medicare & Medicaid Services (CMS) has finalized its 2019 Outpatient Prospective Payment System rule, which will gradually institute site-neutral payments in the Medicare program over the next two years. CMS is using site neutral payment to level the playing field between what physician offices and hospital outpatient departments are paid for certain clinical visits.

The agency said site-neutral payments for clinic visits will result in lowering of out-of-pocket costs for beneficiaries and save the program as much as $380 million in 2019.

This has surfaced another battle between the nation’s largest hospital association and the Trump administration. The American Hospital Association (AHA) signaled its intent to challenge the new policy in court as it argues that the administration has crossed its boundaries.

Executive Vice President, Tom Nickels said in his statement that this decision clearly exceeds the administration’s legal authority. The AHA joined by the AAMC and member hospitals will be prompt in bringing a court challenge to the new rule’s site-neutral provisions. He believes that the rule will hit patients in rural and vulnerable communities.

Value based care solutions helps to deliver better health outcomes. But, some challenges are still faced by patients.