Despite 2019 Judgment, Site Neutral Cuts Set to Rise to 60% in 2020
In early December, the Centers for Medicare and Medicaid Services (CMS) stated it will automatically reprocess 2019 claims in order to repay Olympic Medical Center and other hospitals for its reductions to payments to off-site, hospital-based outpatient clinics.
Olympic Medical Center joined the American Hospital Association (AHA), the Association of American Medical Colleges and other hospitals in filing a lawsuit against the Department of Health and Human Services over the payment cuts. The courts ruled in favor of the AHA lawsuit in September, saying that CMS exceeded its statutory authority in implementing the 2019 cuts, and in October the judge reaffirmed her previous order to CMS to vacate the payment cut.
Despite this ruling, CMS declared its intent to reduce payments in 2020 to 60%, and on December 16, a federal judge said hospitals must file claims in 2020 to show the effects of cuts.
CMS also filed its intent to appeal the 2019 ruling last week.
Out of due diligence, Olympic Medical Center officials planned for CMS to continue cuts and built the loss of funding into the 2020 budget, squeezing investments for growth and needed technologies; however, current services will continue to be maintained. As this plays out in the courts, our advocacy team continues to talk with elected officials about what adequate reimbursement means to our community.
U.S. House Representative Derek Kilmer earlier this year introduced The Protecting Local Access to Care for Everyone (PLACE) Act, as a vehicle to halt the CMS rulemaking related to these cuts. Representative Kilmer continues to build bipartisan support for this bill.