AHA asks MedPAC for 3.2 percent pay bump in fiscal 2016

The American Hospital Association has asked the Medicare Payment Advisory Commission (MedPAC) to act on a draft proposal that it bump up acute care hospital inpatient and outpatient payments by 3.2 percent in fiscal 2016, AHA News Now reported.

In an eight-page letter to MedPAC Chairman Glenn Hackbarth, AHA's Linda E. Fishman, senior vice president of public policy analysis and development, aired the organization's wishes for the coming fiscal year.

It praised the 3.2 percent proposed payment increase, appreciating the fact that MedPAC has acknowledged that the average margin on Medicare for a hospital in the current fiscal year is negative 9 percent. It also said it appreciated MedPAC's analysis of how sequestration cuts impact hospital operations.

However, the lobbying group remains staunchly opposed to a proposal that would balance out payment rates for 66 identical procedures performed in both hospital outpatient departments and physician offices. That proposal, if enacted, would cut payments to hospitals by more than $1.4 billion a year.

The AHA said that it strongly opposed the change, noting that the world of reimbursements has changed somewhat dramatically since it was introduced in 2010. In the intervening years, ambulatory payment classifications have changed and been bundled, which the AHA said MedPAC has not taken into account. It asked the body to withdraw the proposal until the completion of a full study of its impact on payments to hospitals.

The AHA also asked that the commission withdraw a proposal to set long-term care hospital payment rates for non-critical chronically ill patients to those of inpatient hospital rates. The lobbying group noted that the Bipartisan Budget Act of 2013 addressed that specific issue by implementing some site-neutral payment rates for specific cases. It added that MedPAC should instead support implementation of what has been signed into law.

The AHA also asked MedPAC to reduce payment differences between short inpatient stays and similar outpatient stays, and blunt some of the authority recovery audit contractors have in clawing back payments to claims that are in dispute. MedPAC had proposed a DRG for short-hospital stays but has no plans as of yet for implementing it.

MedPAC is expected to announce its final intent on the proposals later this year.

To learn more:
- read the AHA News Now article
- check out the AHA's letter (.pdf) 

 

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