Neither ambulatory surgery centers nor hospital outpatient departments got good news last week when the Medicare Payment Advisory Commission (MedPAC), the independent commission that advises Congress on Medicare payment policy, released its final recommendation for Medicare pay rates in 2015.

ASCs. MedPAC adopted a final recommendation to freeze payments for ambulatory surgical centers. This is the second straight year MedPAC has recommended a 0% pay raise for ambulatory surgery centers.

Hospital outpatient departments. MedPAC recommended increasing hospital inpatient and outpatient prospective payment systems by 3.25% in the absence of sequestration cuts and 5.25% if spending cuts continue. The sequestration that begun last April enacted automatic 2% Medicare payment cuts for the next 10 years.

MedPAC also suggested applying a site-neutral payment policy to a set of 12 surgical service APCs, which would reduce HOPD payment to the level paid in an ASC, resulting in HOPD payments cuts of $590 million per year, says the American Hospital Association. Payment to hospitals for outpatient care should reflect HOPD costs, not physician or ASC payments, says the AHA in a letter to MedPAC.

Dan O'Connor