Nearly 40 hospitals have filed a joint lawsuit in opposition to the Centers for Medicare & Medicaid Services’ site-neutral payment policy for Medicare-covered outpatient services.
In the suit, the hospitals charge the federal government with overstepping its authority in implementing such a change through regulation in the face of past congressional action to limit the use of site-neutral payments.
Under its site-neutral payment policy, Medicare pays the same for some outpatient services regardless of where those services are provided. Under Medicare’s previous policy, Medicare paid more for services provided in hospital-run outpatient facilities.
Hospitals argue that their outpatient facilities are more resource-intensive than ordinary doctors’ offices and that larger payments are justified. CMS maintains that its site-neutral payment policies will save Medicare beneficiaries $150 million through reduced co-payments and increase competition among providers.
Learn more about the lawsuit, the issue, and the arguments for and against site-neutral Medicare outpatients payments in the Fierce Healthcare article “38 hospitals sue HHS over site-neutral payment policy.”