Tag archives: off-campus

Court of Appeals Upholds HHS Site-Neutral Payment Cuts to Off-Campus Provider Based Departments

On Friday, July 17, 2020, the Court of Appeals for the District of Columbia found in favor of the U.S. Department of Health and Human Services (“HHS”) by holding that Medicare Part B payment cuts to certain services provided to Medicare beneficiaries in off-campus provider-based departments (“PBDs”) are within the agency’s statutory authority. More specifically, … Continue reading

CMS Agrees to Pay for Clinic Visit Services Furnished in Excepted Off-Campus Provider-Based Departments at the Full OPPS Rate

CMS has announced that it will reimburse hospitals for clinic visit services furnished in excepted off-campus provider-based departments at the full OPPS rate without the payment reduction set forth in the agency’s CY 2019 OPPS final rule. CMS explains that it has installed a revised OPPS Pricer to update the payment rates applied to claim … Continue reading

U.S. District Court vacates CY 2019 OPPS final rule reducing Medicare payment rates for evaluation and management services furnished in hospital excepted off-campus provider-based departments

On September 17, United States District Judge Rosemary M. Collyer, United States District Court for the District of Columbia, ruled that CMS in its CY 2019 OPPS final rule reducing Medicare payment rates for evaluation and management (E/M) services furnished to Medicare beneficiaries in hospital excepted off-campus hospital provider-based departments exceeded its statutory authority and … Continue reading

CMS 2017 OPPS Proposed Rule includes Medicare payment provisions for hospital off-campus outpatient departments

On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) published its Calendar Year (CY) 2017 Outpatient Prospective Payment System Proposed Rule.  We will be providing an in-depth analysis of all significant proposals shortly.  In the interim, we note that significant provisions of the rule would implement Bipartisan Budget Act of 2015 Section … Continue reading
LexBlog