Modern Healthcare Quotes John Jacob on Hospital Outpatient Pay Rate Cut Exemptions

Akin Gump health care and life sciences practice head John Jacob has been quoted in the Modern Healthcare article “CMS reevaluating hospital outpatient pay rate cut exemptions.” The article reports that the Centers for Medicare & Medicaid Services (CMS) is reconsidering applications from hospitals for exceptions from reimbursement cuts to their off-campus outpatient facilities following pushback from the industry.

Without the exception, the article says, reimbursement rates fall to 40 percent of the full outpatient prospective payments system rate. In addition, hospitals would be liable for certain overpayments issued starting January 1, 2018.

Jacob said he would be surprised, and concerned, if many of the initial denials were not overturned. “Hospitals were facing the untenable position of returning millions of dollars in purported Medicare overpayments that they truly believed were proper payments for the outpatient care provided to their patients,” he stated.