MedPAC discusses, but doesn’t equalize pay rates

In recent discussions, the Medicare Payment Advisory Commission (MedPAC), for the first time, proposed equalization between hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) for certain procedures, according to the ASC Association.

The talk was continued from an earlier discussion on site-neutral payments for similar services provided by Medicare, according to the ASCA.

However, the March report to Congress calls for eliminating the update for ASCs in 2014 and requiring ASCs to submit cost data.

“Once again, we find MedPAC’s recommendations frustrating and short-sighted,” says Bill Prentice, CEO of ASCA. “The commission is recommending a payment update that fails to take into account the escalating costs that ASCs face in providing care and proposing a burdensome reporting program that will increase costs for both ASCs and the federal government.”

MedPAC should support ASCs and the cost savings they offer with an annual ASC update linked to the hospital market basket measure that is used to update HOPDs, Prentice maintains.

The report details fee-for-service payment recommendations for 2014 approved by the commission in January, according to the American Hospital Association (AHA). The recommendations call for a 1% increase in hospital outpatient and inpatient prospective payment system payments, the AHA says. For inpatient services, MedPAC recommends that CMS use the difference between the 2014 statutory update and the recommended 1% increase to offset the costs of changes in hospitals’ documentation and coding.

The report can be accessed at