Mark Miller, MedPAC’s Executive Director, testified before the House Ways and Means Committee last week to discuss MedPAC’s Annual Report to Congress, Medicare Payment Policy, which was released March 15, 2017.  In his testimony (available here), and in Chapter 3 of the Annual Report (available here), MedPAC addressed the growth in stand-alone emergency departments (EDs).  The number of hospitals with an off-campus emergency department increased by 97% between 2008 and 2016, and by 2016, there were over 500 stand-alone EDs.  Roughly 65% of these are hospital affiliated off-campus emergency departments.  Mr. Miller noted that “the mix of patients served by stand-alone EDs more closely resembles the mix of patients treated at urgent care centers than the mix of patients treated in on-campus hospital EDs.”  MedPAC’s concern is that because Medicare pays the same rate to stand-alone EDs as it does to on-campus hospital EDs, Medicare might be overpaying for services.  Mr. Miller also explained that these stand-alone EDs are not tracked by CMS, and nothing in the claim differentiates whether the care was provided at a stand-alone ED or an on-campus ED.  Thus, MedPAC recommended that hospitals be required to add a modifier on claims for services provided at a stand-alone ED to allow CMS to track payments to these facilities.