Equal pay discussed for ASC procedures

MedPAC submits report to Congress

The Medicare Payment Advisory Commission's (MedPAC's) June report to Congress includes a chapter reviewing several proposals to expand site-neutral payments, the American Hospital Association (AHA) reported. The report discusses equalizing payments for certain surgical services commonly furnished in ambulatory surgical centers, which would reduce hospital payments for 12 surgical ambulatory payment classifications (APCs) by $590 million, the AHA said.

Another proposal would expand the site-neutral policy to 66 additional APCs, which would reduce hospital payments by another $900 million, the organization said. MedPAC expects to continue discussing the proposals in the fall, the AHA said.

"AHA believes that it was premature and ill-advised for MedPAC to include a site-neutral payment policy chapter in its report," said Joanna Kim, AHA vice president for payment policy. "Given the complexity involved in crafting a site-neutral payment policy, we believe that a more robust analysis of impact should have been conducted before this issue was committed to a published chapter."

The potential cuts could have a significant impact, Kim said. "Although MedPAC staff did not provide exact estimates, based on the information provided, the impact of implementing site-neutral payments as described in the chapter would likely be well over $2 billion in a single year, reducing payments to the chronically underfunded Medicare outpatient system by 5.5%, and reducing hospitals' Medicare outpatient margins from negative 11% to negative 17%, all else being equal," she said.

To access the report, go to http://www.medpac.gov/documents/Jun13_EntireReport.pdf.