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Judge halts CMS' site-neutral pay cuts for hospitals

A federal judge ruled against the 2019 Medicare Outpatient Prospective Payment System final rule's site-neutral payment policy that reduced Medicare payments for off-campus clinic visits.

 

Four things to know:

1. The final rule reduced off-campus provider-based department visits by 60 percent, which aimed to cut reimbursement rates to hospitals by $380 million in 2019 and $760 million in 2020. The American Hospital Association, Association of American Medical Colleges and others sued HHS to end the site-neutral payments.

2. The judge sided with the challengers, stating that CMS did not follow the statutory process for setting Medicare payment rates.

3. CMS is no longer able to move forward with reduced hospital rates as planned.

4. The challengers also requested the court require CMS to make payments that were withheld as a result of the final rule, but the judge denied that request for the moment.

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