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AAMC Urges Conference Committee Not to Cut HOPDs to Pay for SGR

January 20, 2012—The AAMC Jan. 17 sent a letter  to the House-Senate conference committee  urging them to reject the cuts to hospital outpatient departments (HOPDs) that were included in H.R. 3630 and recently recommended by the Medicare Payment Advisory Commission (MedPAC) Jan. 12 [see Washington Highlights, Jan. 13].  The conference committee will meet to address the differences between competing House and Senate bills to extend the sustainable growth rate (SGR) patch, which will expire at the end of February, as well as several other tax-related provisions [see Washington Highlights, Jan. 6].

In the letter, the AAMC advises the committee that cuts to HOPDs, used to offset the cost of the SGR extension in the House-passed H.R. 3630 should not be included in the final compromise bill.  The AAMC is concerned that cuts to teaching hospital HOPDs “will result in reduced access to patient care and would adversely impact medical resident training in these facilities.” The letter warns that “[t]he proposed HOPD cuts are counter-productive, as they are likely to result in the closure of some HOPDs and the reduction of services in others, greatly affecting the vulnerable populations—especially those with complex medical problems—that receive care there, and limiting the ability to train the next generation of health professionals in these outpatient settings.”

The AAMC letter emphasizes that while MedPAC voted in favor of the recommendation to equalize payments between physician offices and HOPDs, it did so “without any further study of possible beneficiary impacts.” MedPAC did recommend that the Secretary of Health and Human Services (HHS) study the impact of HOPD payment changes and issue a report in 2015.  The AAMC letter questions the usefulness of the study, stating, “While it is certainly helpful that a policy of this magnitude is phased-in, and a limited stop loss is allowed, AAMC strongly believes the proposed changes should be studied before they are implemented. A study released well after the policy is implemented would be too late for those HOPDs that have already closed, reduced their services or moved resident training out of these sites as a result of this change.”  Finally, it warns that “[i]mplementing the proposed HOPD cuts will have a disproportionate impact on America’s teaching hospitals, physicians who work in these settings and the patients they serve.”

The letter to the conferees clearly states that the AAMC supports preventing cuts to physicians by repealing or extending the SGR patch, but “[they] do not support making HOPD changes as a way to pay for the SGR.”


Len Marquez
Director, Government Relations
Telephone: 202-862-6281


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