This week, House members are working to complete a two-year, $70 billion budget agreement that would avert a sharp rise in Medicare Part B premiums, among other changes.
As a partial offset for freezing Part B premiums, the 143-page agreement would reduce payments to any new hospital outpatient facility or physician practice acquired after enactment and located 250 yards or farther from a hospital’s main campus. Those new facilities and practices would be paid through either the Ambulatory Surgical Center Payment System or Medicare Physician Fee Schedule, as opposed to the Outpatient Prospective Payment System (OPPS).
The agreement includes a grandfather exemption for existing facilities and practices, which would continue to be paid under the OPPS.
Upon learning of this damaging provision, America’s Essential Hospitals fought hard to exempt essential hospitals, arguing that the provision would have a chilling effect on new ambulatory care in underserved areas. The association worked with members of the House Committee on Rules to introduce an amendment proposing the exemption. But the amendment failed on a party-line vote late Tuesday. America’s Essential Hospitals will continue working with lawmakers to remove this provision.
In committee business, the Senate Committee on Health, Education, Labor, and Pensions will hold a hearing Thursday on mental health and substance use disorders.
Meanwhile, the House leadership debate seems to be easing as Committee on Ways and Means Chair Paul Ryan (R-WI) has stepped up to run for speaker to replace Rep. John Boehner (R-OH), who will retire at the end of the month. Ryan is expected to receive enough votes to secure the post.