 Health Care | Health Care |
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CMS targets hospitals with site-neutral drug rule |
The Trump administration is proposing an expansion of a policy that will require Medicare to pay the same rate for the same service, regardless of whether it's delivered in an outpatient hospital or independent physician office. |
The proposal takes a direct shot at the hospital industry, which has long opposed so-called site neutral plans. Hospitals currently get reimbursed more for off-campus outpatient care than physician offices or ambulatory surgical centers, a source of significant frustration for some lawmakers and fiscal hawks who argue equalizing the payment rates would save taxpayers billions of dollars. Bipartisan site-neutral plans were debated in Congress last year with the hope of being included in a year-end spending deal, but a deal did not materialize. In a proposed rule issued Tuesday, the Centers for Medicare and Medicaid Services (CMS) took a significant step in that direction. The agency proposed reducing payments for outpatient drugs delivered in hospitals and off-campus facilities. CMS said the move will help ensure beneficiaries aren't penalized with additional copays "simply based on where they receive care." The agency estimated the site-neutral provision would reduce outpatient spending by $280 million; Medicare would save $210 million, and Medicare beneficiaries would save $70 million in the form of reduced coinsurance. The American Hospital Association pushed back on the proposal. "Studies show hospital outpatient departments are more likely to serve Medicare patients who are sicker, more clinically complex, and more likely to be disabled or living in poorer, rural communities than patients treated in independent physician offices," the group said in a statement. |
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How policy will be impacting the health care sector this week and beyond: |
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President Trump on Wednesday signed legislation aimed at cracking down on illegal fentanyl and toughening prison sentences for those who traffic the drug. Trump signed the Halt All Lethal Trafficking of Fentanyl Act at a White House ceremony, where he was joined by lawmakers and individuals whose family members have died from fentanyl overdoses. The president called the bill signing a "historic step toward justice for every … |
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Maine Family Planning filed a lawsuit Wednesday against the Trump administration seeking to restore Medicaid funding that is set to be stripped under the president's sweeping tax and spending package. A provision in the law bans health care providers that perform abortions and receive more than $800,000 in federal reimbursements from receiving Medicaid funding for one year. Republicans included the provision in the legislation … |
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States and mental health organizations are bracing for the closure of a specialized service within 988, the National Suicide and Crisis Lifeline, for LGBTQ youth on Thursday under orders from the Trump administration amid its broader spending cuts and the dismantling of programs dedicated to diversity and inclusion. "When the line goes silent, there are a lot of open questions that we're trying to prepare for," said … |
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Branch out with a different read from The Hill: |
Weight loss drugs may lower risk of dementia, stroke: Study |
Some popular weight loss drugs may lower the risk of dementia and stroke for patients with Type 2 diabetes and obesity, new research published in JAMA Network suggests. Patients taking semaglutide or tirzepatide medications — active ingredients in weight loss drugs such as Ozempic, Mounjaro and Wegovy — showed a lower risk of developing certain diseases compared to those taking other, similar medications. Those include neurodegenerative … |
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A MESSAGE FROM ASTRAZENECA |
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Local and state headlines on health care: |
- Republican cap student loan debt. Here's why that's bad for California medical students (Cal Matters)
- Chicago's Rush University Medical Center pausing gender-affirming care for minors (CBS)
- Michigan health insurers seek more double-digit rate hikes (the Detroit Free Press)
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Health news we've flagged from other outlets: |
- On super hot days, this insurance plan pays out cash for lost wages (NPR)
- Upended by meth, some communities are paying users to quit (The New York Times)
- NIH official fired amid probe of contract used to potentially hire spouse, officials say (The Washington Post)
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Opinions related to health submitted to The Hill: |
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You're all caught up. See you tomorrow! |
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