News & Perspectives

A U.S. Court of Appeals Panel Upholds Health and Human Services (HHS) Medicare Outpatient Off-Site Payment Reduction Policy

27. July 2020 Sam Fish Health

On July 17, 2020, a panel of the U.S. Court of Appeals for the District of Columbia reversed a lower court decision and held that the HHS policy of reducing Medicare payment to off-site outpatient hospital sites for certain services did not have to be budget neutral.

HHS reduced the reimbursement for these services to the amounts being paid for similar services performed at doctors’ offices.

The panel held that HHS’ policy of reduction could be justified under its authority to control the volume of these services.

The case is American Hospital Association v. Secretary of HHS, No. 19-5352.