Examining Possible Congressional Relief and CMS Guidance

This month, hospitals impacted by Section 603 of the Bipartisan Budget Act of 2015 (BBA) may finally get a glimpse of what the future holds for the off-campus departments they operated or were developing when the BBA was enacted on November 2, 2015. Section 603 introduced site neutrality for new off-campus outpatient departments, eliminating the payment differential between provider-based and freestanding locations. The BBA left open many important questions that hospitals need answered to make financial and operational decisions.

On June 7, the U.S. House of Representatives passed H.R. 5273, the Helping Hospitals Improve Patient Care Act, which, among its many provisions, included potential relief for cancer hospitals and hospitals that can certify a new off-campus outpatient department was in “mid-build” when the BBA was enacted. Guidance addressing implementation of the site-neutral reimbursement policy is promised by the Centers for Medicare & Medicaid Services (CMS) in the annual Outpatient Prospective Payment System (OPPS) rulemaking, expected later this month.