Opportunity to Comment to CMS on Provider-Based Billing Moratorium | Brouse McDowell | Ohio Law Firm

Opportunity to Comment to CMS on Provider-Based Billing Moratorium

on April 21, 2016

        Following the unexpected and very sudden moratorium on new hospital off-campus provider-based departments in Section 603 in the Bipartisan Budget Act of 2015 -- including departments currently in development or under construction -- hospitals have been weighing their options for their off-campus departments. Particular areas of concern include the ability to expand or relocate existing departments and how the Centers for Medicare & Medicaid Services ("CMS") will treat those departments under construction. Hospitals have been looking forward to CMS rule-making to address and clarify these issues.

        The good news is that CMS has stated that it will present its proposals for implementing the moratorium through the 2017 Outpatient Prospective Payment System Proposed Rule. The Proposed Rule is expected to be published in July of this year. This is an excellent opportunity for affected facilities to submit comments and questions and to describe scenarios regarding the implementation of the moratorium for CMS' consideration. Potential scenarios to highlight to CMS include the ability of existing sites to expand their footprint or service lines, the ability of existing sites to relocate to new addresses, and the treatment of departments that are under development but were unable to bill provider-based prior the effective date of the moratorium.

 Comments should be emailed to CMS at Provider-BasedDepartments@cms.hhs.gov. (Following the issuance of the proposed rule, there will be a standard notice and comment period as part of the rule-making process prior to the issuing of the final rule.)

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