News & Analysis as of

Bipartisan Budget Act OPPS

Baker Donelson

CMS Proposes Major "Site-Neutral" Changes to Payments for Off-Campus Locations

Baker Donelson on

CMS recently published its proposed Medicare outpatient prospective payment system (OPPS) rule for calendar year (CY) 2019. The rule contains a number of "site-neutral" proposals that, if adopted, will result in lower...more

McGuireWoods LLP

2018 Reimbursement Cuts for Some Off-Campus Hospital Provider-Based Departments

McGuireWoods LLP on

On Nov. 2, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized a rule changing reimbursement rates under the Medicare Physician Fee Schedule (MPFS) for certain non-excepted hospital off-campus provider-based...more

King & Spalding

CMS Reminds Providers to Identify Off-Campus Provider-Based Departments on Enrollment Forms

King & Spalding on

In connection with CMS’s implementation of Section 603 of the Bipartisan Budget Act of 2015 (BBA15), which directs CMS to no longer pay hospitals the full OPPS rate for services furnished in non-excepted off-campus...more

Baker Donelson

CMS Releases the 2016 OPPS Final Rule

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On November 1, 2016, CMS published its final policy changes, quality provisions, and payment rates for 2017, as they relate to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center...more

King & Spalding

CMS Finalizes Policies on Off-Campus Provider-Based Status CMS Will Pay Non-Excepted PBDs in 2017, But Adopts Nearly All Other...

King & Spalding on

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...more

Poyner Spruill LLP

Proposed 2017 Hospital OPPS Rule Would End Medicare Payments to Many Off Campus Facilities at the Same Levels as Hospital-Based...

Poyner Spruill LLP on

Published on July 14, 2016, CMS’s proposed 2017 Hospital Outpatient Prospective Payment System (OPPS) rule calls for site-neutral payments that would stop Medicare payments to many off-campus facilities at the same level as...more

King & Spalding

Also In The News - Health Headlines - August 2016

King & Spalding on

CMS Provides Update Regarding Patient Status Review Delay – On July 27, 2016 CMS posted an update regarding Quality Improvement Organization (QIO) reviews of patient status claims, which are currently paused. CMS notes that...more

BakerHostetler

Provider-Based Status Post-BBA: CMS Offers Limited Answers, Requests More Feedback

BakerHostetler on

For those in the hospital industry hoping for additional clarity regarding the operation and billing of provider-based departments (PBDs), the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule provides some...more

K&L Gates LLP

CMS Releases Details on Site-Neutral Payment Provision under Bipartisan Budget Act

K&L Gates LLP on

On July 6, the Centers for Medicare and Medicaid Services (“CMS”) released the Medicare hospital outpatient prospective payment system (“OPPS”) and the Medicare ambulatory surgical center (“ASC”) payment system proposed rule...more

Dorsey & Whitney LLP

CMS Issues Proposed Rule Addressing Off-Campus Outpatient Departments

Dorsey & Whitney LLP on

The Centers for Medicare and Medicaid Services (CMS) published its 2017 Medicare Outpatient Prospective Payment System (OPPS) proposed rule on July 14, 2016 (the Proposed Rule). In part, the Proposed Rule addresses CMS’s...more

Mintz - Health Care Viewpoints

CMS Releases Proposed Outpatient Payment System Rule for 2017, Leaving Hospitals Unhappy

Last week, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System for 2017. CMS...more

Foley & Lardner LLP

“Site Neutrality” for Off-Campus Outpatient Departments: Proposed Rule is Worse than You Expected!

Foley & Lardner LLP on

CMS issued its Outpatient Prospective Payment System (“OPPS”) Proposed Rule for 2017 (the “Proposed Rule”) on July 6, 2016. The Proposed Rule will be published in the Federal Register on July 14, 2016. One highly-anticipated...more

Polsinelli

CMS Proposes Amendments to Payments Furnished from Provider-Based Departments

Polsinelli on

As part of the CY 2017 proposed Hospital Outpatient Prospective Payment System rules (OPPS) the Centers for Medicare and Medicaid Services (CMS) released the long awaited proposed payment changes for items and services...more

Baker Donelson

Proposed Provider-Based Changes Pose Significant Problems for Hospitals

Baker Donelson on

As we reported in a Payment Matters article last November 12, 2015, Section 603 of the Bipartisan Budget Act of 2015 changes the payment rules applicable to off-campus, provider-based locations that are new as of November 2,...more

McDermott Will & Emery

CMS Proposed Rule Implements Limitations on Medicare Payments for Off-Campus Outpatient Hospital Departments

McDermott Will & Emery on

In Depth - Background - On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) released the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule, which includes proposed regulations to...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes to Limit Site Neutral Payment Exceptions Applicable to Certain Off-Campus Hospital Departments Following Relocation,...

On July 6, 2016, CMS released the 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule which, among other things, implements Section 603 of the Bipartisan Budget Act of 2015. Despite extensive lobbying efforts by...more

King & Spalding

CMS Proposes Changes to Provider-Based Status in CY 2017 OPPS Rule - Agency takes aggressive view of Section 603 of Bipartisan...

King & Spalding on

On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule. The Proposed Rule includes several provisions regarding how CMS will...more

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