Budget Deal Moves to Fix Higher Hospital Charges to Cancer Patients

The budget deal that Congress is expected to vote on as early as today also includes a provision for “site neutral” payments to hospital off-campus facilities, sick such as acquired physician practices. Starting in 2017, sale Medicare will not pay higher rates to hospital-owned practices off-campus to the main facility. Existing hospital-owned practices are grandfathered.

On Monday, pill ASCO released a policy statement that  justified higher payment rates for cancer services, which not only increase Medicare spending but seniors’ out-of-pocket costs. However, with a contrary view, COA Executive Director Ted Okon told Inside Health Policy that, “Medicare should not subsidize emergency care with a system that encourages hospitals to buy private physician practices so they can charge more for physician services. He noted that congressional Medicare payment advisers recommended similar site-neutral policies.”

“Cancer doctors are not the focus of the site-neutral measure, but oncology services are a good example of the pay disparity between hospital outpatient and physician offices,” Okon said. “It’s common for patients to be hit with significantly higher bills for chemotherapy from one cycle to the next because in the interim a hospital bought the practice, even though they’re receiving chemotherapy at the same office, staffed by the same providers.”

“It’s about time,” Okon said of the site-neutral policy.