Hospital groups are threatening to sue the Trump administration for cutting Medicare payments for visits to clinics residing in hospitals.
The Centers for Medicare & Medicaid Services released a final rule on Friday outlining the cut to reimbursements for outpatient hospital departments, which include clinics or surgical centers. CMS lowered the reimbursements for such clinic visits to bring them in line with the reimbursements it gives out for visits to regular doctors’ offices, which are lower.
But a few hours after the rule was released on Friday, the American Hospital Association threatened to sue the administration over the “ill-advised” cuts.
“Congress recognized the crucial role of hospital outpatient departments in the communities they serve and, in 2015, specifically protected existing facilities from unwarranted payment reductions,” the AHA said in a statement. “Today’s final rule could stifle hospitals’ ability to modernize care to meet the needs of their patients and communities.”
But the administration said that the new rule, which will be phased in over two years, would result in seniors paying lower copayments for such visits.
Currently, the average Medicare payment for a hospital-based clinic visit is about $116, and the senior’s copay of that amount would be $23. But under the new cut, Medicare would pay $81 and the copay would be $16.
The AHA said that it has been joined by the American Association of Medical Colleges and member hospitals to look into bringing a court challenge to the new rule.
The AHA and other hospitals also sued the administration over a proposal to cut a drug discount program, called 340B, that mandates drugmakers provide discounts to drugs for safety-net hospitals that cover a certain amount of low-income patients. A federal judge dismissed that lawsuit earlier this year because it was too premature as the rule hadn’t been finalized.
The hospital groups re-filed their lawsuit in September.
