HHS responds to site-neutral payment challenge

Keith A. Reynolds

The U.S. Supreme Court has not yet accepted or declined to hear the suit between the AHA and HHS.

The Department of Health and human Services (HHS) is asking the U.S. Supreme Court to affirm a lower court’s ruling upholding site-neutral health care billing.

HHS has filed its response to a petition seeking to throw out a rule enforcing parity in Medicare reimbursements no matter where certain services are provided. The court has not indicated whether it would hear the case, but if they choose not to, the rule will stay in place.

The case is rooted in a challenge to HHS’ implementation of site-neutral payments for outpatient services. The American Hospital Association (AHA) and a host of other organizations has asked the Supreme Court to hear their arguments against the rule.

The rule requires hospital outpatient off-campus departments to receive the same reimbursements as independent physician offices for services given to Medicare patients. The AHA has said that the rule will harm patients because those seen at these hospital-owned of campus departments are more likely to be from lower income areas, suffering from more severe chronic conditions, and previously hospitalized.

The original case contended that HHS’ actions fell outside of the agency’s statutory authority, which was accepted by the district court which heard the arguments. The U.S. Appeals Court for the District of Columbia reversed that judgment July 17. The AHA and its fellow plaintiffs are hoping the high court will back their challenge which could toss out the rule.