In its June 2018 Report to the Congress the Medicare Payment Advisory Commission (MedPAC) recommends that Congress reduce Medicare Type A emergency department payment rates by 30 percent for services furnished in hospital off-campus emergency departments that are located within six miles of a hospital on-campus emergency department.  MedPAC also recommends that Congress should enable isolated rural off-campus emergency departments that are located more than 35 miles from another hospital emergency department to bill standard Medicare outpatient prospective payment system facility fees and provide such emergency departments with annual payments to assist with fixed costs.

MedPAC’s June 2018 Report to the Congress is available here.