On November 2, 2015, President Obama signed into law the Bipartisan Budget Act of 2015 (BBA 2015). BBA 2015, Section 603 generally provides that beginning January 1, 2017, off-campus hospital outpatient departments (HOPDs) will no longer be paid under the Medicare outpatient prospective payment system (OPPS) but rather under another applicable payment system, provided the requirements for such payment are met. Section 603 included two exceptions to the general rule, one applying to dedicated emergency departments and another for departments of a provider that were billing under the OPPS for covered outpatient department services furnished prior to the date of enactment (November 2, 2015). On June 7, the U.S. House of Representatives approved by voice vote the Helping Hospitals Improve Patient Care Act of 2016. Section 201 of the legislation would amend BBA 2015, Section 603, in two significant respects. First, under the legislation an off-campus HOPD is deemed to be billing under the Medicare OPPS with respect to covered outpatient department services furnished prior to November 2, 2015, if the Secretary received from the hospital prior to December 2, 2015, a provider-based attestation demonstrating that such department was a department of a provider. Second, under an alternative exception and effective for OPPS payments beginning in 2018, an off-campus HOPD would not be subject to the general rule included in BBA 2015, Section 603 if three conditions are met: (i) the Secretary receives from the hospital an attestation for the HOPD no later than December 31, 2016 (or if later 60 days after the date of enactment); (ii) the hospital includes the HOPD on its enrollment form in accordance with Medicare requirements; and (iii) the HOPD meets the “mid build” criterion, requiring that before November 2, 2015, the hospital had a binding written agreement with an outside unrelated party for the actual construction of the HOPD. The bill must be signed by the President before it becomes law.