In a September 17, 2019 decision, the United States District Court for the District of Columbia invalidated a CMS rule expanding site-neutral payment reductions to evaluation and management (E&M) services furnished in...more
10/22/2019
/ Administrative Authority ,
Bipartisan Budget Act ,
Budget Neutrality Policy ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Intent ,
Hospitals ,
Lack of Authority ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Provider Payments ,
Remand ,
Ultra Vires ,
Vacated
CMS took another step in its campaign to impose "site neutrality" on hospital outpatient payments with its recently published final Medicare hospital Outpatient Prospective Payment System (OPPS) rule for CY 2019. The final...more
12/14/2018
/ Biologics ,
Centers for Medicare & Medicaid Services (CMS) ,
Emergency Rooms ,
HCPCS ,
Health Care Providers ,
Hospitals ,
Medicare ,
MedPAC ,
Off-Campus Departments ,
OPPS ,
Outpatient Services ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Provider Payments ,
Section 340B ,
Site-Neutral Exception
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
8/8/2018
/ Bipartisan Budget Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Hospitals ,
Medicare ,
Medicare Payment Reform ,
Off-Campus Departments ,
OPPS ,
Outpatient Prospective Payment System (OPPS) ,
Provider Payments ,
Section 340B ,
Trump Administration
CMS recently published its final outpatient prospective payment system (OPPS) rule, which includes its new policies governing payment related to services furnished at off-campus provider-based departments (OPBDs). 81 Fed....more
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
Hospitals have long tried to expand their footprints by developing, or in many instances acquiring, physician practices and other medical operations to provide services beyond the immediate vicinity of the hospital’s campus....more