Bill that would equalize hospital, off-campus Medicare payments advances out of committee

The "Helping Hospitals" bill aims to provide relief from a 2015 policy revision that lowered the rate at which Medicare reimbursed off-campus doctors' offices.
By Susan Morse
04:31 PM
Share

One of the bill's main features is turning back the clock - for some facilities - on a policy of the Bipartisan Budget Act of 2015.

The U.S. House Ways and Means Committee has passed the "Helping Hospitals Improve Patient Care Act," a bill that, among other things, aims to provide financial relief to hospitals that were in the process of building off-campus outpatient centers in 2015 when reimbursement policy changed.

Ways and Means Health Subcommittee Chairman Pat Tiberi, R-Ohio, and Ranking Member Jim McDermott, D-Washington, introduced the bipartisan legislation last week. It has received support from the American Hospital Association, the Federation of American Hospitals and the Association of American Medical Colleges.

One of the bill's main features is turning back the clock - for some facilities - on a policy of the Bipartisan Budget Act of 2015 that lowered the rate at which Medicare reimbursed off-campus doctors' offices owned by hospitals. Prior to the budget act, clinics off-campus were reimbursed at the same rate as hospitals.

The reasoning was that hospitals incurred higher expenses. Also, supporters believed the budget act policy would reduce hospitals' incentive to acquire physician offices.

The ACA and other hospital groups criticized the policy, saying it would block access to healthcare for patients who used off-campus, outpatient clinics.

The Helping Hospitals Improve Patient Care Act, or H.R. 5273, pays off-campus hospital outpatient departments the higher Medicare Hospital Outpatient Department rate for those facilities that were in the process of mid-build from Nov. 2, 2015 to Dec. 31,2016, or 60 days after enactment of the budget act, whichever is later.

Newer facilities are capped at the lower physician fee schedule rate.

"For those select HOPDs that would qualify, this legislation is a significant relief, and we are supportive of the legislation on their behalf," said American Hospital Association Executive Vice President Tom Nickels. "AHA also supports provisions in the bill that would adjust the Hospital Readmissions Reduction Program to account for socioeconomic status, and extend the Rural Community Hospital Demonstration Program for five years."

The legislation also gives improved consideration of socioeconomic status in the Hospital Readmissions Reduction Program, that levies fines over excessive readmissions.

It also delays CMS's authority to terminate contracts for Medicare Advantage plans failing to achieve minimum quality ratings as it conducts research and reports on socioeconomic status and quality ratings.

Finally, the bill allows hospitals providing cancer care to continue to be paid at cancer hospital rates at new off-campus locations; extends a program dealing with the reimbursement of small rural hospitals for five more years; and exempts physicians who treat patients in ambulatory service centers from the Electronic Health Records Incentive Program and the Merit-Based Incentive Payment System.

Ways and Means Committee Chairman Kevin Brady, R-Texas, said  the bill, "provides some necessary regulatory relief to providers and makes it easier for beneficiaries to enroll in Medicare."

Twitter: @SusanJMorse


Follow Healthcare Finance on Twitter and LinkedIn.