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AAMC and AHA File Lawsuit Contesting Cuts to Outpatient Departments

December 7, 2018

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PRESS CONTACTS
Ivy Baer, Senior Director and Regulatory Counsel

The AAMC and the American Hospital Association (AHA) filed a lawsuit Dec. 4 against the Department of Health and Human Services in response to payment reductions included in the calendar year 2019 Outpatient Prospective Payment Schedule (OPPS) final rule issued by the Centers for Medicare and Medicaid Services (CMS).

In a joint statement issued by the AAMC and the AHA, AAMC President and CEO Darrell G. Kirch, MD, said, “It is alarming that CMS continues to propose cuts that will harm the teaching hospitals that provide care to the most vulnerable patients, including Medicare beneficiaries. Patients who seek care at teaching hospital off-campus outpatient departments often can only find care at these institutions. Successfully managing the complex medical needs of these patients requires considerable resources and coordination, and hospital outpatient departments are best positioned to provide that level of care.”

The final rule includes a policy that will decrease reimbursement for clinic visits furnished at off-campus provider-based departments paid under the OPPS. When Congress passed legislation that cut some payments under the OPPS, these outpatient departments were specifically excluded. The lawsuit contends that the cuts exceed the agency’s statutory authority and will be harmful to teaching hospitals that care for the most vulnerable patients.

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