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Hospitals to Congress: Drop Payment Cap Proposal

John Commins, for HealthLeaders Media, September 14, 2012

The nation's four largest hospital associations and their allies at medical schools urged Congress in a letter this week to oppose a cap on payments for outpatient services in hospitals.

AHA Letter to Congress

>>>
Letter to Congress
The cap proposal was floated earlier this year by the Medicare Payment Advisory Commission, which estimates that it could save the federal government about $1 billion.

Under the proposal, for non-emergency examinations in a hospital outpatient setting the physician would get the standard amount for the service in a hospital setting. The hospital would get the difference between the physician office payment minus the physician payment in the hospital.

The hospital associations say the proposal would reduce payments by at least 71% for 10 of the most common outpatient hospital services.

"Simply put, it is significantly damaging to beneficiaries and the providers on which they rely to enact legislation that will result in such large cuts. We urge you to oppose inclusion of these cuts in any legislation, and appreciate your continued support of our hospital and its patients," the letter stated.

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1 comments on "Hospitals to Congress: Drop Payment Cap Proposal"


Lawrence Lewis, CEO, PMHD (9/19/2012 at 11:23 AM)
The proposed payment cap that would reduce hospital payments to the difference between hospital based ER visits and physician office patient visits, does not consider the burden that is placed on hospitals to see EVERY patient that arrives on campus seeking maedical care. It does not take into consideration the cost of maintaining a service 24X7 that is prepared to see patients of any condition and unknown medical history from a pulled chest muscle resulting from a cough or sneeze, to a blockage that could ultimately end up with open heart sugery. They do not consider the patients that walk in with a headache due to lack of sleep to a pain symptomatic of a brain aneurism. Proposed signficant changes to compensation structures should be researched thoroughly and based on the cost of providing the services that are being required of a hospital emergency rooms. This is why it's important for legislators to develop working relationships with the hospital associations that engage industry leaders in collaborating to develop sound proposals.