Judge urged to enforce Medicare ruling

OMC among those asking for hearing

WASHINGTON, D.C. — Hospitals, including Olympic Medical Center, have asked a federal judge to enforce her ruling that Trump administration could not slash Medicare reimbursements for off-site clinics.

Earlier this month the Centers for Medicare and Medicaid Services implemented the second phase of a site-neutral rule that cuts Medicare reimbursements at clinics more than 250 yards away from a hospital’s main campus by 60 percent.

This comes after the federal government lost lawsuits filed by the American Hospital Association and Association of American Medical Colleges. A similar lawsuit was also filed by dozens of hospitals across the country.

A federal judge ruled in September that CMS “Exceeded its statutory authority when it cut the payment rate for clinic series at off-campus provider-based clinics.”

On Nov. 11 the American Hospital Association asked the court to enforce its September ruling and requested a hearing.

“The 2020 [Outpatient Prospective Payment System] Rule purports to continue a ‘two-year phase-in’ of the site neutral payment policy finalized in the 2019 OPPS Rule — a payment policy this Court vacated in September,” the motion to enforces judgment says.

“To be clear, CMS has not just issued another rule that is unlawful for the same reasons as the 2019 OPPS Rule. The agency has reinstated the second year of the two-year phase-in that was promulgated … in the now-vacated 2019 OPPS Rule. That violates this Court’s vacatur order.”

When the government implemented the 60 percent cuts, it acknowledged the lawsuit that it had lost.

“We do not believe it is appropriate at this time to make a change to the second year of the two-year phase in of the [vacated] clinic visit policy,” the government wrote on a fact sheet.

“The government has appeal rights, and is still evaluating the rulings and considering, at the time of this writing, whether to appeal from the final judgment.”

Olympic Medical Center became a named plaintiff in the American Hospital Association’s lawsuit against the federal government earlier this year, and successfully argued that CMS did not have the authority to implement a “site neutral” rule. The government is expected to appeal.

The policy, which threatens to cost OMC more than $47 million in lost revenue over the next decade, led to Olympic Medical Center halting expansion of primary care in Sequim.


Reporter Jesse Major can be reached at 360-452-2345, ext. 56250, or at [email protected] dailynews.com.

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