Patients across Nevada also face barriers to health care access due to staff shortages. Remove liability for services rendered for payers that are not billed in accordance with this section’s requirements. Direct HHS to treat outpatient departments as subparts of the parent organization and to issue these subparts unique provider identifiers. Require that health systems establish and bill using a unique National Provider Identifier number for each and every off-campus outpatient department. Prevent off-campus emergency departments from charging higher rates than on-campus emergency departments when standalone emergency facilities are located in close proximity to a hospital campus. End exceptions to the 2015’s Bipartisan Budget Act site-neutral payment requirements, which exempted most facilities from fair billing requirements. The bill (S.1869), titled the Site-based Invoicing and Transparency Enhancement (SITE) Act, would ensure that Medicare reimburses care fairly for off-campus services, regardless of who owns the provider. Site-neutrality has been the rare issue to attract bipartisan support, and has been a platform initiative for Presidents Barack Obama, Donald Trump, and Joe Biden. Even before the pandemic, the healthcare system was becoming increasingly more consolidated causing rising costs and no clear indications of quality improvements. The current billing structure incentivizes hospitals to acquire private practices to then upcharge patients at the higher hospital rate. This issue has become more prevalent as independent physician-owned practices are increasingly acquired by larger hospital systems. The Congressional Budget Office estimated that taxpayers will pay close to $40 billion in excess costs to Medicare due to exorbitant facility fee payments over the next decade. This results in higher hospital rates charged to the patient. The bill has been referred to the Senate Committee on Finance, of which Nevada Senator Catherine Cortez Masto (D-NV) is a member.ĭue to Medicare’s current billing structure, even if care is received at an off-campus outpatient facility, it can be billed as though the care was provided at the main hospital campus. Senate by Senators Mike Braun (R-IN), Maggie Hassan (D-NH), and John Kennedy (R-LA). Most recently, a bipartisan bill (S.1869) has been introduced in the U.S. Expanding site-neutral payment in Medicare has become the most popular and effective solution, with the introduction of several bills and discussion drafts seeking to fix the Medicare billing structure that allows hospitals to charge higher rates than independently-owned practices. As Medicare appropriations continue to increase, policymakers have been focused on ideas to reduce costs while preserving access to care for beneficiaries.
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