WHA Expresses Concern to Federal Lawmakers Over Trump 2020 Budget Health Care Provisions

Site-neutral expansion, 340B requirements among most concerning provisions

March 26, 2019

In a letter sent to Wisconsin’s Congressional Delegation last week, WHA alerted federal lawmakers to concerning health care provisions included in President Trump’s proposed FY2020 budget. The budget proposes hundreds of billions in cuts to hospitals over the next 10 years in areas such as bad debt and uncompensated care payments, graduate medical education, and post-acute care. Most notable, however, is a proposed expansion of site-neutral payment policies and new requirements for 340B hospitals

The proposed budget would create a new user fee for every drug purchased by 340B hospitals while requiring the Health Resources and Services Administration (HRSA) to promulgate new regulations on 340B entities. Additionally, it proposes to expand site-neutral payment policies to services delivered at both off-campus and on-campus hospital outpatient departments (HOPDs), a policy expected to reduce payments to hospitals by $160 billion over the next 10 years. This would be on top of CMS’ 2019 Outpatient Rule which applied site-neutral payments to clinic visits at off-campus HOPDs only; WHA previously estimated that policy will cost Wisconsin hospitals approximately $425 million over the next 10 years.

While presidential budgets typically serve as political documents during divided government, they may also be used as negotiating points as Congressional packages are developed. In the letter, WHA thanked those in Wisconsin’s Congressional Delegation who expressed past concern to CMS over expanding site-neutral policies, while asking them to focus instead on comprehensive payment reform that encourages the type of high-quality, high-value health care Wisconsin is known for. Additionally, instead of new regulations on 340B, WHA encouraged lawmakers to focus on the proposals in the Trump budget that would ease regulations, such as the call to eliminate the 96 hour rule for Critical Access Hospitals and Stark Law Reform.

For more information, contact WHA Director of Federal and State Relations Jon Hoelter.

This story originally appeared in the March 26, 2019 edition of WHA Newsletter