"Now, raise your hand if you would support legislation that equalizes such payments at the doctor rate so folks can have more access to care and a bill that they can afford."
Support legislation that equalizes Medicare payments for the same services across hospital-owned clinics and independent physician offices.
Occurrences
"If we just did what President Obama suggested in his budget, what Joe Biden included in his budget, and yes, Donald Trump included in his budget in his first administration, we could save $160 billion..."
"I think there are absolutely opportunities as we look at site neutrality, to look where things aren’t reasonable."
Support legislation that equalizes Medicare payments for the same services across hospital-owned clinics and independent physician offices.
Evidence
CRS's May 22, 2026 update says CMS's CY2026 OPPS/ASC final rule extended site-neutral payment to Part B drug administration, with OPPS/ASC payment equal to PFS beginning January 1, 2026. It also says broader expansion still raises congressional and legal questions.
CRFB reported that the Ways and Means Committee hearing chaired by Jason Smith highlighted high hospital prices and discussed reforms addressing site-of-service payments, nonprofit hospitals, 340B, and related cost issues.
Congress.gov lists Rep. Jason Smith as sponsor of H.R.4822. The bill included Section 203, 'Parity in Medicare payments for hospital outpatient department services furnished off-campus,' and limited the specified services to drug administration APCs.
Congress.gov shows H.R.5378 passed the House on December 11, 2023. Section 203 would substitute an applicable Part B payment amount for specified off-campus OPD services, defined as drug administration APC services, with a phase-in.
The House Clerk records Roll Call 708 as passed, 320-71, on H.R.5378. The vote list shows Smith (MO), Republican, Missouri, voted Yea.
The Ways and Means release says H.R.5378 was led by Chair Jason Smith and would lower out-of-pocket costs for seniors receiving medication at a hospital-owned outpatient facility through Medicare payment reforms.
CMS finalized expansion of its site-neutral policy to drug administration services furnished in excepted off-campus provider-based departments, applying the Physician Fee Schedule equivalent rate to codes assigned to drug administration APCs.
Assessments
Smith clearly supported and materially advanced site-neutral Medicare payment legislation in the 118th Congress, including sponsoring H.R. 4822 and leading the House passage of H.R. 5378. But those measures only targeted a narrower subset of services, especially drug administration in off-campus hospital outpatient departments, rather than fully equalizing Medicare payments for the same services across hospital-owned clinics and independent physician offices. The later CMS rule also produced only a limited administrative version of the policy, not the broader legislative equalization promised. That supports partial credit, with meaningful effort, but not full delivery.
Smith materially supported and advanced Medicare site-neutral payment legislation: he sponsored H.R.4822, led the House package H.R.5378, and voted for the House-passed bill. However, those provisions covered only specified off-campus outpatient drug administration services, not broad equalization of Medicare payments for the same services across hospital-owned clinics and independent physician offices. CMS later finalized a similar limited site-neutral policy for drug administration beginning in 2026, so the policy outcome was only partially achieved during his federal service.