Rep. Kilmer urges Congress to act on bill to restore HOPD policy

Rep. Derek Kilmer, D- Wash., today urged support for his legislation – the Protecting Local Access to Care for Everyone Act (H.R. 2552) – which would prevent payment reductions for hospital outpatient clinic visit services furnished in off-campus provider-based departments that are grandfathered under Section 603 of the Bipartisan Budget Act of 2015.

“It is essential that Congress act to ensure its legislative intent is upheld in law and to prevent further damage to health care access, especially in rural areas,” Kilmer said today before the House Energy and Commerce Committee.

In a letter of support for the bill when it was introduced, AHA said “Congress clearly intended to preserve the existing outpatient payment rate for these excepted off-campus PBDs because of the critical role they play in their communities. But CMS's [the Centers for Medicare & Medicaid Services’] rules for 2019 run counter to this, and instead will impede access to care for the most vulnerable patients. Your bill will restore the policy Congress intended and ensure that hospitals can continue to treat patients in the outpatient setting in their home communities."

CMS reduced payments for off-campus hospital outpatient department clinic visits under the outpatient prospective payment system final rule for calendar year 2019, prompting the AHA and Association of American Medical Colleges, along with three individual hospitals, to file a lawsuit alleging the agency acted outside the law.