Episode 20: Our Take July–Part 3

John shares our take on what happened in health care at the end of July, including how the Centers for Medicare and Medicaid Services is proposing both a rule for site-neutral payments, as well as potentially more 340B cuts.

• The Centers for Medicare and Medicaid Services (CMS) has proposed a rule to move toward “site neutral” payments for clinic visits, under the 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Clinic visits are “essentially checkups with a clinician,” CMS said, and are the most common service billed under OPPS.
• CMS proposed to reduce 340B payments in 2019 to non-excepted off-campus departments of hospitals that are paid under the physician fee schedule. Earlier this year, CMS had already reduced $1.6 billion in Medicare outpatient drug payments to some 340B hospitals.