In a letter to the Centers for Medicare & Medicaid Services, NAUH has conveyed its opposition to aspects of CMS’s proposed Medicare outpatient prospective payment system regulation for 2019.  Once adopted, this regulation will determine how the federal government pays hospitals and some physicians for Medicare-covered outpatient services in calendar year 2019.

Aspects of the proposed regulation that NAUH opposes include:

  • reducing outpatient payments to exempted off-campus provider-based departments to site-neutral rates;
  • reversing a recent policy that permitted hospital-based outpatient facilities to be paid outpatient fee system rates rather than physician fee schedule rates for new services provided within clinical families of services; and
    reducing payments for 340B-covered prescription drugs when provided by off-campus provider-based physician.

In each of these situations, NAUH maintains that the proposed policy fails to reflect the significant differences in the roles played by hospital-based physician practices and private physician offices in the health care infrastructure of the communities in which they are located.

See the complete NAUH letter to CMS here.