Sens. Bill Cassidy and Maggie Hassan are set to release a framework for Medicare site-neutral payment reforms as early as Friday.
Why it matters: Changes to the way hospitals are paid for outpatient procedures could be on the agenda in a lame duck session, and this framework fleshes out more options.
- Site-neutral proposals address the way hospitals charge Medicare more for the same services that independent doctors deliver in their offices.
What’s inside: The framework is slated to be more expansive than some previous site-neutral policies and could look similar to what’s been proposed in the June 2023 MedPAC report.
- MedPAC recommended that for certain services, Medicare payments to hospital outpatient departments, ambulatory surgery centers and freestanding physician offices should be more closely aligned.
- That means this policy would apply to a number of outpatient services that could be provided in each type of setting.
- The savings from the site-neutral policy could then be reinvested into certain hospitals.
While the hope is to get the framework out by Nov. 1, the timeline could slip. The goal is to release it before the election though, sources said.
- Both Cassidy and Hassan’s offices declined to comment.
The big picture: Hassan has previously been a leader on site-neutral payments with her SITE Act, but Cassidy’s involvement adds an influential Republican, who could potentially be HELP chair next year.
- The health cost transparency bill that the House passed last year only applied site-neutral payments to physician-administered drugs.
- Any site-neutral bill still faces an uphill climb this year given hospital opposition, and many expect a smaller policy like the House measure to have the best chance if anything makes it.
Hassan, Cassidy prep site-neutral framework
axios.com
November 1, 2024 2:51 pm
Sens. Bill Cassidy and Maggie Hassan are set to release a framework for Medicare site-neutral payment reforms as early as Friday.
Why it matters: Changes to the way hospitals are paid for outpatient procedures could be on the agenda in a lame duck session, and this framework fleshes out more options.
- Site-neutral proposals address the way hospitals charge Medicare more for the same services that independent doctors deliver in their offices.
What’s inside: The framework is slated to be more expansive than some previous site-neutral policies and could look similar to what’s been proposed in the June 2023 MedPAC report.
- MedPAC recommended that for certain services, Medicare payments to hospital outpatient departments, ambulatory surgery centers and freestanding physician offices should be more closely aligned.
- That means this policy would apply to a number of outpatient services that could be provided in each type of setting.
- The savings from the site-neutral policy could then be reinvested into certain hospitals.
While the hope is to get the framework out by Nov. 1, the timeline could slip. The goal is to release it before the election though, sources said.
- Both Cassidy and Hassan’s offices declined to comment.
The big picture: Hassan has previously been a leader on site-neutral payments with her SITE Act, but Cassidy’s involvement adds an influential Republican, who could potentially be HELP chair next year.
- The health cost transparency bill that the House passed last year only applied site-neutral payments to physician-administered drugs.
- Any site-neutral bill still faces an uphill climb this year given hospital opposition, and many expect a smaller policy like the House measure to have the best chance if anything makes it.