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Statement on 2018 Outpatient Prospective Payment System Final Rule


Statement attributable to:
Bruce Siegel, MD, MPH
President and CEO
America’s Essential Hospitals

WASHINGTON — Today’s Medicare Outpatient Prospective Payment System (OPPS) final rule jeopardizes health care access for millions of low-income individuals and families nationwide and weakens the ability of essential hospitals to provide vital services to communities.

We see no reasonable rationale for diverting Medicare Part B reimbursement from hospitals in the 340B Drug Pricing Program — those in greatest need of support — to providers not eligible for 340B discounts. Congress clearly intended that the 340B program help hospitals that care for many vulnerable patients; this new policy subverts that goal.

Essential hospitals operate with an average margin less than half that of other hospitals and depend on 340B program savings to stretch resources for patient care and community services. Given their fragile financial position, essential hospitals will not weather this policy’s 27 percent cut to Part B drug payments without scaling back services or jobs.

The Centers for Medicare & Medicaid Services (CMS) has offered no evidence these payment cuts would achieve its stated policy goal: to combat rising drug prices. Instead, this policy weakens the 340B program’s value as a tool to lower prices while raising costs and administrative burdens on hospitals least able to absorb these changes.

America’s Essential Hospitals, the American Hospital Association, and the Association of American Medical Colleges believe CMS has overstepped its statutory authority with this policy, and the groups plan legal action to stop it.

We will take all steps necessary to stop this and other harmful policies that threaten access to high-quality hospital care for all people, especially those who face economic and social hardships.

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About America’s Essential Hospitals
America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

Our 325 members are vital to their communities, providing primary care through trauma care, disaster response, health professional training, research, public health programs, and other services. They innovate and adapt to lead the broader health care community toward more effective and efficient care.

Carl Graziano


About the Author

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