August 23, 2018

HOP Panel Advises Against Site Neutral Proposals

The Advisory Panel on Hospital Outpatient Payment has recommended that the Centers for Medicare and Medicaid Services (CMS) not implement site neutral policies covered in the Calendar Year (CY) 2019 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule.

Based on a discussion at its Aug. 20, 2018 meeting, the advisory panel specifically recommended that CMS not implement proposed payment reductions for both clinic visits and expanded clinical families of services at excepted off-campus departments. Several panel members suggested an increase in clinic visits are a result of a shift of site of service from inpatient visits to outpatient visits. The panel recommended that CMS continue to study site neutral topics.

The panel also asked CMS to publish its methodology and details about how it plans to package data for each major type of packaged cost, including fees associated with clinical lab tests and ancillary services that will be packaged when it releases annual Ambulatory Payment Classification (APC) offset files. The panel advised CMS to publish this data with the proposed and final rules to allow for stakeholder comment.

CMS is accepting comments on the CY 2019 HOPPS proposed rule until 5 pm on Sept. 24, 2018. The ACR is developing comments to submit to CMS on key issues.