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This week the House passed a health care package containing site neutral payments, equalizing Medicare payment between hospital outpatient departments and doctors’ offices for administering medicines. Though the legislation is unlikely to pass the Senate and become law as-is, it’s success passing through the House in a bipartisan manner makes it more likely for the bill to be included in a government funding deal. The health care package would also rein in some practices by pharmacy benefit managers and codify health care price transparency requirements. It would also stave off pay cuts for safety-net hospitals and fund community health centers. Unfortunately, the site-neutral provision is being seen as a pay-for for delaying Medicaid DSH cuts slated to take effect January 19^th. While the financial hit to hospitals would only be $3 billion, expanding site neutral payments could be the beginning of a slippery slope to more site neutral payment reforms.