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- House Lawmakers Advance Proposals on Price Transparency and Site-Neutral Payments
The House Energy and Commerce Committee advanced legislation to institute site-neutral Medicare payment cuts to hospital outpatient departments and modify hospital price transparency requirements. The CAP, along with other groups such as the American Hospital Association (AHA), has opposed these proposals and is concerned burdensome measures will negatively affect hospital-based practices and patient access to services.
HR 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023, includes a section to increase price transparency of clinical diagnostic laboratory tests under Medicare. The section would require laboratories to make publicly available the discounted cash price, the de-identified minimum rate, and de-identified maximum rate for clinical diagnostic laboratory tests offered by the lab to be included in the list of shoppable services specified by the CMS.
The utility of price transparency efforts has been questioned in the past as patients often can’t shop for such services. The requirements also create extra burdens for hospitals and physicians.
The site-neutral payment cuts would apply to drug services furnished in an off-campus, provider-based department. According to the AHA, the cut would amount to $54.2 million over the first year and $3 billion over 10 years. “This legislative effort would expand existing site-neutral payment cuts, which have already had a significantly negative impact on the financial sustainability of hospitals and health systems and have contributed to Medicare’s chronic failure to cover the cost of caring for its beneficiaries,” the AHA said.