Washington Healthcare News
wahcnews.com
Articles, Jobs and Consultants for the Healthcare Professional

OPPS Final Rule Finalizes Limits for Off Campus Departments

First few Article Sentences

On November 1, 2016, the Centers for Medicare and Medicaid Services (CMS) issued the long-awaited implementation of the "site-neutrality" provisions of the H.R. 1314 Bipartisan Budget Act of 2015 (BiBA Section 603). The Final Rule will cause new (non-grandfathered, post 11/2/2015) hospital off-campus outpatient departments to no longer be reimbursed under the Medicare Outpatient Prospective Payment System (OPPS). Rather, those locations are deemed "nonexcepted" clinics and will receive something less than 50% of the old OPPS rate (at least initially) to approximate Medicare Physician Fee Schedule (MPFS) payment. In other words, the former financial advantage to locations holding provider-based status will largely disappear for new outpatient projects, with total payment (physician and technical component) approximating what would be paid for the service if performed in a free-standing physician office.


Vernaglia, Lawrence W.

Storey Cheryl

Moss Adams LLP

CMS Site-Neutrality

November 1, 2016

back to library