On November 1, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2017 Outpatient Prospective Payment System (OPPS) Final Rule, which includes the agency’s final policies implementing legislative changes to treatment of off-campus provider-based departments (PBDs). These changes are the result of Congress’s passage of Section 603 of the Bipartisan Budget Act of 2015, which directs CMS to no longer pay hospitals the OPPS rate for services furnished in off-campus PBDs beginning January 1, 2017 – unless such PBD is a dedicated emergency department, is located within 250 yards of a remote inpatient hospital campus, or had been billing under the OPPS prior to November 2, 2015.
Many commenters had urged CMS to delay implementation of Section 603 until it could better operationalize its proposals. The agency declined to delay implementation but made two significant changes from the Proposed Rule to address hospital concerns.
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