The House Energy and Commerce Committee is seeking input on Section 603 of the Bipartisan Budget Act of 2015, which established a site-neutral payment policy for newly-acquired, provider-based, off campus hospital outpatient departments (HOPD) after November 2, 2016.  In an open letter to the health care community, the Committee explains the origins of the policy, noting that it was enacted as a result of concerns that the Medicare hospital outpatient prospective payment system paid more for the same services provided at HOPDs than in other settings, such as an ambulatory surgery center, physician office, or community outpatient facility.   The letter discusses evidence the Committee considered in establishing this policy, but notes that the Committee has received significant feedback on this provision since enactment, with concerns raised about the provision’s potential impact on hospitals, beneficiaries, and providers.  The Committee has received a range of recommendations from the public, with stakeholders urging the Committee to:

  • Make no modifications to statute;
  • Make the current Section 603 policy retroactive including picking up currently grandfathered facilities;
  • Enact additional site-neutral policies across the Medicare program;
  • Adopt legislation previously examined by the Health Subcommittee that would further payment neutrality in spaces such as post-acute care and oncology;
  • Explore refinements to issues surrounding expansion, grandfathering or relocation of existing HOPDs and evaluate concerns expressed by physician-owned hospitals; and
  • Ensure that the savings achieved by Section 603 not be reversed, or that any modifications be offset with reductions in the same provider space.

The Committee is inviting interested members of the health care community to provide formal feedback on policies the Committee should examine in the context of Section 603 and other changes to site neutral payment policies.  Feedback is requested by February 19, 2016 for consideration in the coming year.