Advocates for the hospital field are going to ask Congress to rework some provisions of the budget legislation passed this week by the House and the Senate.

American Hospital Association officials are particularly concerned about sections of the bill that would change the payment structure for care in new provider-based outpatient departments. "While the budget deal will ensure the government’s doors stay open, we’re deeply disappointed that it creates some restrictions on payments for care at new provider-based hospital outpatient departments, eroding a service vital to many sicker, poor, minority and senior patients, especially in rural communities," wrote Rick Pollack, AHA president and CEO, in a blog posting. "We worked to ensure some flexibility, and limits to the site-neutral provision; for example, it only applies to future arrangements, not those now in place. And we’ll urge Congress to make further changes in the coming weeks," Pollack wrote.

Similarly, Darrell Kirch, M.D., president and CEO of the Association of American Medical Colleges, said of the AAMC’s concerns, “Most troubling is a policy that would change reimbursement for hospital outpatient departments. This change could limit the ability of teaching hospitals to provide access to care for all patients in their communities.” 

Both associations say they plan to work with Congress to adjust those restrictions.

The bill also extends the Medicare sequester that reduces Medicare reimbursement by 2 percent for one year.

The bill is expected to be signed quickly by the president before the nation reaches the debt limit on Nov. 3.