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Congressional Committee Seeks Comments Regarding Medicare Site Neutral Payment Policies
February 5, 2016

The House of Representatives Energy and Commerce Committee today issued a press release and letter to health care stakeholders requesting feedback on Medicare site neutral payment policies, and in particular, refinements to the recent site neutral provision for Hospital Outpatient Departments (HOPD) passed in Section 603 of the Bipartisan Budget Act, which was signed in to law November 2, 2015.  Pursuant to this legislation, any off-campus HOPD, other than a dedicated emergency department, that did not bill Medicare for HOPD services before November 2, 2015 will be subject to a site neutral payment rate outside of the outpatient hospital prospective payment system as of January 1, 2017.

The letter from Chairman Fred Upton (R-MI) and Health Subcommittee Chairman Joseph Pitts (R-PA), reviews the history of this issue, including previous policy recommendations from the Medicare Payment Advisory Commission (MedPAC) and the Government Accountability Office (GAO).  In the letter, the Committee notes that it has received a "large amount" of feedback on Section 603 and briefly summarizes concerns that have been expressed regarding its impact on beneficiaries, hospitals, and other providers.

The letter requests further information and recommendations to inform the Committee's work moving forward.  The letter specifically notes that stakeholders have thus far urged the Committee to, among other things, expand site neutrality to other spaces, such as post-acute care and oncology;  and eliminate exemptions or refine rules surrounding the grandfathering, expansions, and relocations of existing HOPDs.

For those providing feedback, the Committee requests that proposals exclude any recommendations that would add to the federal deficit or harm the Medicare Trust Fund in any way. Comments are due to the Committee by February 19, 2016.  

If we can provide help in any way please contact Hope Levy-Biehl or John Hellow in LosAngeles at 310.551.8111; Steve Lipton or Katrina Pagonis in San Francisco at 415.875.8500; or Marty Corry or Robert Roth in Washington, D.C. at 202.580.7700.

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