{"id":44896,"date":"2025-07-16T20:01:00","date_gmt":"2025-07-17T01:01:00","guid":{"rendered":"https:\/\/ustower.net\/?p=44896"},"modified":"2025-07-16T21:47:07","modified_gmt":"2025-07-17T02:47:07","slug":"cms-targets-hospitals-with-site-neutral-drug-rule","status":"publish","type":"post","link":"https:\/\/ustower.net\/?p=44896","title":{"rendered":"CMS targets hospitals with site-neutral drug rule"},"content":{"rendered":"\n<p class=\"has-medium-font-size\">The Trump administration is proposing an expansion of a policy that will require Medicare to pay the same rate for the same service, regardless of whether it\u2019s delivered in an outpatient hospital or independent physician office.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">The proposal takes a direct shot at the hospital industry, which has long opposed so-called&nbsp;<strong>site neutral plans<\/strong>. &nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\">Hospitals&nbsp;<strong>currently get reimbursed<\/strong>&nbsp;more for off-campus outpatient care&nbsp;than physician offices or ambulatory surgical centers, a source of significant frustration for some lawmakers and fiscal hawks who argue equalizing the payment rates would save taxpayers billions of dollars.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">Bipartisan site-neutral plans&nbsp;<a href=\"https:\/\/thehill.com\/policy\/healthcare\/4966764-site-neutral-medicare-payment-plan-cassidy-hassan\/?email=467cb6399cb7df64551775e431052b43a775c749&amp;emaila=12a6d4d069cd56cfddaa391c24eb7042&amp;emailb=054528e7403871c79f668e49dd3c44b1ec00c7f611bf9388f76bb2324d6ca5f3&amp;utm_source=Sailthru&amp;utm_medium=email&amp;utm_campaign=CMS 7.16 Health\"><u>were debated<\/u><\/a>&nbsp;in Congress last year with the hope of being included in a&nbsp;<strong>year-end spending deal<\/strong>, but a deal did not materialize. &nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\">In a proposed&nbsp;<a href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-and-ambulatory-surgical?email=467cb6399cb7df64551775e431052b43a775c749&amp;emaila=12a6d4d069cd56cfddaa391c24eb7042&amp;emailb=054528e7403871c79f668e49dd3c44b1ec00c7f611bf9388f76bb2324d6ca5f3&amp;utm_source=Sailthru&amp;utm_medium=email&amp;utm_campaign=CMS 7.16 Health\"><u>rule<\/u><\/a>&nbsp;issued Tuesday, the Centers for Medicare and Medicaid Services (CMS) took a significant step in that direction.&nbsp;The agency proposed&nbsp;<strong>reducing payments<\/strong>&nbsp;for outpatient drugs delivered in hospitals and off-campus facilities.&nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\">CMS said the move will help ensure&nbsp;<strong>beneficiaries<\/strong>&nbsp;<strong>aren\u2019t penalized<\/strong>&nbsp;with additional copays \u201csimply based on where they receive care.\u201d&nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\">The agency estimated the site-neutral provision would reduce outpatient spending by $280 million; Medicare would save $210 million, and Medicare beneficiaries would save&nbsp;$70 million in the form of reduced coinsurance.&nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\">The American Hospital Association pushed back on the proposal.&nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\">\u201cStudies show hospital outpatient departments are more likely to serve Medicare patients who are sicker, more clinically complex, and more likely to be disabled or living in poorer, rural communities than patients treated in independent physician offices,\u201d the group said in a statement. &nbsp;<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><a href=\"https:\/\/thehill.com\/newsletters\/health-care\/5405321-trump-administration-takes-shot-at-hospitals\/\">thehill<\/a><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Trump administration is proposing an expansion of a policy that will require Medicare to pay the same rate for the same service, regardless of whether it\u2019s delivered in an outpatient hospital or independent physician office. The proposal takes a direct shot at the hospital industry, which has long opposed so-called&nbsp;site neutral plans. &nbsp; Hospitals&nbsp;currently [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":44897,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5784],"tags":[1226,33998,2861,2258,1230],"class_list":["post-44896","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-attack","tag-cms","tag-drugs","tag-hospital","tag-trump"],"_links":{"self":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/44896","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=44896"}],"version-history":[{"count":1,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/44896\/revisions"}],"predecessor-version":[{"id":44898,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/44896\/revisions\/44898"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/media\/44897"}],"wp:attachment":[{"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=44896"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=44896"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=44896"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}