{
  "schemaVersion": 1,
  "deskKey": "GAO-16-189:congressional-matter",
  "title": "Medicare payments by place of service",
  "page": "https://america.co/oversight/medicare-site-neutral-payments",
  "selectedAction": "Congressional matter",
  "actorType": "congress",
  "owner": "Congress; the selected matter would direct the HHS Secretary",
  "source": {
    "report": "GAO-16-189",
    "url": "https://www.gao.gov/products/GAO-16-189",
    "published": "2015-12-18",
    "publiclyReleased": "2015-12-18",
    "consulted": "2026-10-05",
    "statusInConsultedSource": "Open – Partially Addressed",
    "latestSelectedCommentAsOf": "2026-02"
  },
  "progressSummary": "GAO’s February 2026 comment describes partial action through the 2015 Bipartisan Budget Act and later CMS rules. It also notes a November 2025 rule concerning drug-administration services. The selected matter remains partially addressed rather than closed.",
  "annualContext": {
    "report": "GAO-26-108505",
    "url": "https://www.gao.gov/products/gao-26-108505",
    "published": "2026-05-12",
    "benefitType": "potential-savings",
    "estimateAsReported": "$156.9 billion / 10 years",
    "timeHorizon": "10 years; annual table does not specify dates",
    "estimateAttribution": "CBO, as cited by GAO in May 2026",
    "scope": "Topic-level; not a price tag solely on the selected action",
    "basis": "GAO’s May 2026 annual table cites a Congressional Budget Office estimate of $156.9 billion over 10 years for this topic. This desk has not reproduced the underlying model; the number is a conditional topic-level estimate, not a remaining cash balance."
  },
  "boundary": "Payment changes already adopted matter to any new baseline. A projected federal savings estimate is not a promise that an individual patient’s bill falls by the same amount. Service mix, hospital obligations, and access effects must be evaluated.",
  "evidenceToCloseSummary": "Action that addresses the remaining settings and services identified in the matter, with GAO’s assessment of whether the intent is satisfied. A narrower payment change can be meaningful without closing the entire matter.",
  "proposedEvaluation": {
    "notOfficialProcedure": true,
    "test": "Compare the same defined service and patient circumstances across settings. Identify which payment rules already apply, the baseline year, exceptions, transition policy, and effects on access—not just the gross rate difference.",
    "questions": [
      "Which services and departments are included in the proposal?",
      "Does the estimate incorporate rules already adopted?",
      "What protections preserve necessary access and account for hospital obligations?"
    ]
  },
  "cashAvailable": false,
  "actualSavingsAsserted": false,
  "coverage": "One selected action; not every recommendation in the report",
  "compiler": "America.co public-resource desk; AI-assisted; no expert review claimed"
}