Judge Closes Case on Site-neutral Medicare Payment

Posted on October 24, 2019

U.S. District Court Judge Rosemary Collyer ordered the Trump administration Oct. 21 to reverse Medicare payment cuts that were implemented Jan. 1, 2019, for clinic visits provided at off-campus hospital outpatient departments, regardless of whether the facility was grandfathered under Section 603 of the Bipartisan Budget Act. The 2019 outpatient prospective payment system (OPPS) final rule reduced payment rates for these visits to approximately 70% of the OPPS rate to correspond with the reimbursement rate for physician offices.

In September, Collyer ruled that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority when it finalized the “site-neutral” payment policy for calendar year 2019. At that time, the court vacated the relevant portion of the final rule and returned the matter to the CMS, ordering a status report by Oct. 1 to determine whether additional briefing on remedies was required. The CMS asked that none of the rule be vacated or, alternatively, that it remain in effect while the CMS considered appealing the ruling.

Collyer’s Oct. 21 ruling states that the September order was appropriate and the CMS’ motion to modify the order is denied. For more information, contact Vickie Kunz at the MHA.

 

 



Tags: Medicare, CMS, Vickie Kunz, Bipartisan Budget Act

Posted in: Member News

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