The new budget approved by Congress at the end of October establishes site-neutral payment for provider-based hospital outpatient departments that are created after the bill’s date of enactment. President Obama has said he will sign the bill.
The budget addresses the issue of hospitals acquiring ambulatory surgery centers (ASCs) and classifying them as hospital outpatient departments (HOPDs), which results in higher reimbursement. Based on the approved budget, newly acquired, off-campus HOPDs will not be able to be reimbursed under the hospital outpatient prospective payment system. After Jan. 1, 2017, these locations would be reimbursed at the same rates as ASCs or physician offices, depending on the procedure. “This untested idea may endanger patient access to care, especially among patients who are sicker, the poor, minorities, and seniors who often receive care in hospital outpatient departments,” says Thomas Nickels, executive vice president for government relations and public policy at the American Hospital Association (AHA). “Moreover, rural communities will be most adversely impacted, as hospitals will no longer be able to help physicians in these communities continue to provide access to their patients.”
Existing provider-based outpatient departments will be grandfathered in.
Richard J. Pollack, president/CEO of the AHA, said the organization would urge Congress to change the bill in the coming weeks. (Keep up with breaking news on Twitter @SameDaySurgery.)