Senate Republicans throw cold water on so-called site-neutral hospital pay cuts

WASHINGTON — On its face, a minor policy to make sure Medicare pays hospitals the same as physician offices to administer medications has broad, bipartisan support from think tanks, stakeholders, and academics. But Republicans in the House and Senate are divided over the issue, creating a major obstacle to passage anytime soon.

House Republicans had hoped to use a small cut to hospitals’ Medicare payments to help finance a raft of health policy that’s set to expire in January. But the policy has been stagnant in the Senate, where Republicans aren’t necessarily on board yet, senators told STAT.

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If the Senate truly can’t get on board with the “site-neutral” pay policy, that increases the chances that lawmakers will instead look to so-called PBM reforms to pay for the programs. The Senate Finance Committee this month passed a package of policies governing pharmacy middlemen that on balance saved the government money, and a House Energy & Commerce subcommittee advanced new regulations of pharmacy benefit managers, too.

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