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Statement on Outpatient Prospective Payment System Proposed Rule


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

WASHINGTON, DC — The Centers for Medicare & Medicaid Services’ narrow interpretation of Section 603 of the Bipartisan Budget Act of 2015 threatens to reduce access to badly needed health care services in the nation’s most underserved communities.

The regulatory provisions CMS proposes for new off-campus hospital outpatient departments (HOPDs) fail to recognize the practical challenges of establishing and sustaining health care facilities for vulnerable populations. The agency’s decision to not only limit flexibility, but to withhold hospital payments altogether, will perpetuate health care deserts — urban and rural pockets of poor access to care that persist in all 50 states and the District of Columbia.

The proposed provisions in the Outpatient Prospective Payment System rule go far beyond the statutory language of Section 603 and appear to ignore Congress’ intent to apply an alternative payment system for services delivered in new facilities. Hospital systems that otherwise would seek to enhance access by establishing new clinics in underserved areas will not do so, as this damaging payment policy makes new outpatient centers economically unsustainable.

Essential hospitals support efforts to reduce health care costs, but only when savings can be achieved without harming access and quality. We call on CMS to work with essential hospitals and vulnerable patients to ensure national policies align with these goals.

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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 275 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. Learn more at

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