CMS looks to drop payment for off-campus services by half

The CMS wants to drop by half what Medicare pays when patients receive healthcare at medical facilities that are owned by hospitals but located off their campuses.

The Obama administration last year finalized a rule that paid hospital off-campus facilities the same as hospital-based outpatient departments if they started billing Medicare after Nov. 2, 2015.

The proposal, outlined in the proposed 2018 physician fee pay rule released Thursday, would change the rate from 50% to 25% of the current payment rate.

The more generous payment for off-campus facilities has led to hospitals acquiring physician practices at a rapid clip. But hospitals say the facilities, while increasing their operating costs, allow them to provide greater access to healthcare, especially in underserved areas.

The proposed changes would save an estimated $25 million next year. Among the services affected would include pain management treatment, some x-rays and radiation therapies as well as some behavioral health services.

Congress passed what’s called the site-neutral policy after a 2013 Medicare Payment Advisory Commission report that found Medicare was paying 141% more for a echocardiogram in an outpatient setting than for the same procedure in a doctor’s office.

Comments on the proposed rule are due by Sept. 11.