Share this e-Alert:

Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care


July 2016


CMS Proposes Amendments to Payments Furnished from Provider-Based Departments






Modern Healthcare - by the numbers 2015 - No. 1 Polsinelli - Largest healthcare law firms


For more information about this e-Alert, please contact:


Colleen M. Faddick


Email | Bio


Bragg E. Hemme


Email | Bio


Julius W. Hobson, Jr.


Email | Bio


Ross E. Sallade


Email | Bio


Kyle A. Vasquez


Email | Bio


To learn more about our Health Care practice, to contact one of our Health Care attorneys, or for more Health Care Intelligence, click here.


Related Webinar:

Back to the Future ... Will CMS' Proposed Provider-Based Rules Reshape the Future? Or Will They Rewrite the Past?
Part I of II: Where We Are Today - 7.19.2016
Part II of II: Where We Are Headed in CY 2017 - 7.28.2016


Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care Polsinelli - Health Care View Polsinelli documents on JD Supra  


LinkedIn Twitter Facebook Polsinelli Podcast

As part of the CY 2017 proposed Hospital Outpatient Prospective Payment System rules (OPPS) the Centers for Medicare and Medicaid Services (CMS) released the long awaited proposed payment changes for items and services furnished from off-campus provider-based hospital outpatient departments (Proposed Rule). CMS’ Proposed Rule can be found here.

These proposed payment changes were necessitated by Congress’s passage of Section 603 of the Bipartisan Budget Act of 2015 (Section 603) last fall and evince CMS’ exceptionally narrow interpretation of that provision and threaten the ability of hospital providers to continue growing and expanding existing outpatient service capabilities, thereby constraining the services available to Medicare beneficiaries. Reshaping the Proposed Rule will take a concerted stakeholder effort, so we encourage all hospitals and interested stakeholders to submit comments to CMS. Moreover, to the extent you have any projects under development that would be impacted by the Proposed Rule, if finalized, or projects that are on hold as a result of Section 603, we strongly encourage you to reach out to Polsinelli so that we may assist you in developing a strategy to approach CMS and/or Congressional representatives to ensure your concerns are heard.

The Proposed Rule focuses on the implementation of Section 603 and does not address other downstream implications flowing from the Proposed Rule (e.g., impact on 340B status, cost reporting, etc.) or other areas of long-standing uncertainty, such as space and time-sharing. Within the confines of the Proposed Rule, CMS focused its efforts on developing and explaining its rationale for the proposed regulations surrounding the provision and billing of items and services from excepted and nonexcepted provider-based hospital outpatient departments (PBDs). An excepted PBD includes those off-campus PBDs in existence and billing for services prior to November 2, 2015, or otherwise exempted from Section 603 (e.g., dedicated emergency departments), while a nonexcepted PBD includes those off-campus PBDs that came into existence and billed for services on or after November 2, 2015.

To view the full alert, or to download the pdf, please click here.

For More Information

For questions regarding this information, please contact one of the authors, a member of Polsinelli’s Health Care practice, or your Polsinelli attorney.













Atlanta  Boston  Chattanooga  Chicago  Dallas  Denver  Houston  Kansas City  Los Angeles  Nashville  New York
Overland Park  Phoenix  Raleigh  St. Joseph  St. Louis  San Francisco  Washington, D.C.  Wilmington








real challenges. real answers.SM  
Polsinelli is an Am Law 100 firm with more than 800 attorneys in 19 offices, serving corporations, institutions, and entrepreneurs nationally. Ranked in the top five percent of law firms for client service*, the firm has risen more than 50 spots over the past five years in the Am Law 100 annual law firm ranking. Polsinelli attorneys provide practical legal counsel infused with business insight, and focus on health care, financial services, real estate, intellectual property, mid-market corporate, and business litigation. Polsinelli attorneys have depth of experience in 100 service areas and 70 industries. The firm can be found online at Polsinelli PC. In California, Polsinelli LLP.

* 2016 BTI Client Service A-Team Report







Polsinelli provides this material for informational purposes only. The material provided herein is general and is not intended to be legal advice. Polsinelli is very proud of the results we obtain for our clients, but you should know that past results do not guarantee future results; that every case is different and must be judged on its own merits; and that the choice of a lawyer is an important decision and should not be based solely upon advertisements.

Copyright © 2016 Polsinelli PC.

Connect with us on LinkedIn. Connection with us on Twitter. Connect with us on Facebook. Polsinelli Health Care Technology Health Care