Wednesday, December 18, 2019

Judge refuses to strike down 2020 site-neutral plan — but chides CMS

Samantha Liss Published Dec. 17, 2019
Dive Brief:
·         A federal judge will not stop CMS from implementing its site-neutral payment policy in 2020, according to an opinion filed Monday.
·         In September, the judge ruled in favor of hospitals pushing back against CMS' payment cuts to their off-campus hospital clinics for this year.
·         Despite the judge's ruling, CMS went ahead with plans to implement similar cuts in 2020. The hospital lobby then asked Judge Rosemary Collyer of U.S. District Court for the District of Columbia to apply her previous decision to 2020 as well. She denied this request Monday, noting it is not within the court's jurisdiction.
Dive Insight:
As CMS looks to curb healthcare costs, it has attempted to pay the same rates to hospital-owned facilities as independent physician groups, known as site-neutral payments.
Hospitals balked at the move and filed a lawsuit in an attempt to block the cuts. The hospitals may find success through the courts again but they may have to wait until next year, according to a reading Collyer's ruling.
"In short, regardless of the reimbursement rates CMS may have set in years prior, and whatever the basis for those rates, each year CMS must take new agency action to promulgate new reimbursement rates for the next calendar year. This understanding of the operation of the 2020 Final Rule forecloses the Court's jurisdiction," Collyer wrote.
Her previous ruling in September only applies to the year 2019, she said.
However, Collyer appeared critical of CMS' decision to pursue the same policy for 2020 despite her earlier ruling. She said CMS "clearly disregarded the substance" of the court's earlier finding.
"CMS has now intentionally placed itself in a position to suffer those same alleged harms, which calls its argument into serious question and appears to set the agency above the law," Collyer wrote.
https://www.healthcaredive.com/news/judge-refuses-to-strike-down-2020-site-neutral-plan-but-chides-cms/569189/

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