In a Sept. 9 letter to the Centers for Medicare & Medicaid Services (CMS), America’s Essential Hospitals commented on the calendar year (CY) 2025 Medicare Outpatient Prospective Payment System (OPPS) proposed rule.
The association reiterated its support for CMS’ efforts to advance health equity through payment policies but expressed concerns that the proposed changes did not sufficiently meet the needs of safety net providers. The letter called on CMS to use its authority to codify a federal designation for essential hospitals and use the designation across CMS programs to target funding and other support to essential health systems.
In addition, the association commented on the proposed payment policies and quality reporting proposals of interest to essential hospitals.
Specifically, America’s Essential Hospitals urged CMS to:
- Increase its proposed annual hospital payment update to account for rapidly rising costs of hospital goods and services
- Expand Medicare coverage for formerly incarcerated individuals
- Codify 12 months of mandatory continuous eligibility in Medicaid and the Children’s Health Insurance Program
- Revise the Medicaid clinic exception to expand access to care and target social determinants of health
- Refine the Hospital Commitment to Health Equity measure to reward progress in each domain
- Finalize the Screening for Social Drivers of Health measure with flexibility to allow hospitals to use different screening tools, two years of voluntary reporting, and increased support for essential hospitals’ ability to respond to social drivers of health
- Not finalize obstetrical service requirements to the Medicare conditions of participation
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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