Site-Neutral Back Pay: CMS to Give Hospitals More Money for 2019, Carry Fight Into 2020

The administration agreed to comply with a federal judge’s order that vacated site-neutral payment provisions of OPPS 2019, but it appealed her decision and will keep pushing for related provisions in OPPS 2020.

Officials have decided to do three things: (1) issue back payments to hospitals that endured rate reductions in 2019 due to the site-neutral payment policy, (2) appeal Collyer’s decision with regard to the 2019 rule, and (3) maintain course with site-neutral payment policy in the 2020 rule. (The government filed a notice of appeal Thursday.)

A spokesperson for CMS tells HealthLeaders that the agency began November 4 processing payments in accordance with Collyer’s order for claims dated January 1, 2019, and thereafter. Beginning on January 1, 2020, and for the next few months, the 2019 claims that were paid at the reduced rate will be reprocessed automatically, with no need for providers to take any additional action, the spokesperson said.

Source: https://www.healthleadersmedia.com/finance/site-neutral-back-pay-cms-give-hospitals-more-money-2019-carry-fight-2020