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Analysis

Site-Neutral Payments: Judge Holds Her Ground in Vacating OPPS Provisions

By Steven Porter  
   October 22, 2019

The latest ruling opens the door to a possible appeal by the Trump administration, which has argued it has the authority to impose the rate adjustment.

A month after granting hospitals a major victory in their challenge to site-neutral payment provisions of the 2019 Outpatient Prospective Payment System (OPPS) final rule, U.S. District Judge Rosemary M. Collyer issued a follow-up ruling Monday that declined to delay the effects of her decision.

The government had asked Collyer either to modify her order or impose a 60-day stay, but Collyer rejected both of those requests, siding again with the hospitals that brought the suit. Her decision opens the door to a possible appeal.

The American Hospital Association, which worked with several member hospitals and the Association of American Medical Colleges to bring the suit, said Monday's ruling should result in more money for hospitals that had their reimbursement rates reduced as a result of the 2019 policy.

"Now that Judge Collyer has ruled against both the government's motion to reconsider her opinion and the motion for a stay, the AHA expects CMS to comply with today's order and promptly repay the impacted hospitals to support the work they do for the patients they serve," AHA General Counsel Melinda Hatton said in a statement.

The AHA has also acknowledged, however, that an appeal is expected.

When asked by HealthLeaders whether the government will appeal, a spokesperson for the Centers for Medicare & Medicaid Services said the agency is reviewing the decision and declines to comment on maters of pending litigation.

Related: 2020 Outpatient Proposals: 5 Rules You Should Know From CMS

Related: Judge Grants Hospitals Victory in Site-Neutral Payments Dispute

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.


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