51 senators weigh in on site-neutral payment regulations

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A bipartisan group of 51 senators sent a letter to CMS, calling for flexibility in the implementation of Medicare payment reductions for services provided in new off-campus hospital outpatient departments.

The payment reduction is part of the Bipartisan Budget Act of 2015. Under the provision, off-campus outpatient facilities that started billing Medicare under the Outpatient Prospective Payment System on or after Nov. 2, 2015, will not be eligible for reimbursements under the OPPS.

In their letter to CMS, the senators said certain off-campus HOPDs should be shielded. Specifically, they said off-campus HOPDs that relocate, rebuild, change ownership or types of services should not be subject to site-neutral rates.

The senators, led by Sens. Rob Portman (R-Ohio) and Charles Schumer (D-N.Y.), also urged CMS to use the rule of "reasonable proximity" when evaluating on-campus status. Current regulations define "on-campus" as buildings within 250 yards of the main buildings of the hospital or other buildings that the CMS regional office determines, on a case-by-case basis, to be part of the hospital campus. The senators argued that a strict interpretation of the 250-yard criterion would disadvantage hospitals that are adjacent to barriers such as rivers and wetlands that prevent on-campus expansion.

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