On Friday, February 5, 2016, key Republican leaders of the House Energy and Commerce Committee solicited comments from healthcare stakeholders – including hospitals – regarding the impact of payment changes for off-campus provider-based departments as set forth in section 603 of the Bipartisan Budget Act of 2015. The Committee is seeking feedback from all stakeholders no later than February 19, 2016.  The Committee’s letter is available here.

Section 603 limits payment rates for services furnished in new off-campus provider-based departments to the Medicare Physician Fee Schedule or Ambulatory Surgical Center Payment System rate.  These payment changes take effect on January 1, 2017.  Off-campus departments that were billing Medicare off of the Hospital Outpatient Prospective Payment System before the November 2, 2015 enactment date are included in the statute’s grandfathering provision and will continue to receive hospital outpatient payment rates.  On-campus departments, remote locations of hospitals, satellite facilities and provider-based entities such as rural health clinics are not subject to the payment changes. 

Robust hospital feedback to the Committee’s inquiry may be especially important as the Committee’s letter suggests that Section 603 may only be the start of additional site-neutrality payment policies.  While the letter acknowledges that the Committee is aware of concerns that Section 603 may jeopardize hospitals’ ability to provide care in medically underserved areas, the Committee’s letter also discusses recommendations from MedPAC, the Government Accountability Office and others calling for additional site-neutrality policies for ambulatory procedures and cardiac imaging. 

Reporter, Christopher Kenny, Washington, D.C., + 1 202 626 9253, ckenny@kslaw.com.