News from Washington D.C.

June 2, 2016

Panel Clears Hospital Bill: The House Ways and Means Committee has approved legislation that would extend the time hospitals have to qualify to be grandfathered into the existing payment system for services provided in off-campus, provider-based clinics. Washington Rep. Jim McDermott was the lead Democratic sponsor of the measure. WSHA supported the bill.

The bill revises the so-called “site neutral” provisions of the 2015 Bipartisan Budget Act, which mandates that hospitals are only reimbursed at the lower Medicare physician schedule for services delivered in off-campus, provider-based clinics after Jan. 1, 2017. Hospitals already delivering these services as of Nov. 2, 2015 are not affected by the policy change.

The Ways and Means Committee bill moves the grandfather date from Nov. 2, 2015 to Dec. 31, 2016 or 60 days after enactment, whichever is later. The bill also would require the Centers for Medicare & Medicaid Services (CMS) to consider socio-economic factors in the Hospital Readmission Reduction Program. The bill now moves to the House floor.

House Members Call for Flexible HOPD Rule: A bipartisan group of 235 members of the House of Representatives have urged CMS to be flexible in implementing the off-campus, provider-based clinic provisions of the 2015 Bipartisan Budget Act.

At WSHA’s request, Washington Reps. DelBene, Herrera Beutler, Reichert, Kilmer and Heck signed the letter.

Specifically, they said the “site neutral” provisions of the act should not affect existing off-campus, provider-based clinics that relocate, rebuild, change ownership or types of services and should not affect services provided by a dedicated emergency department.

Fifty-one senators – including Washington Sen. Maria Cantwell – sent a similar letter to CMS. The agency is expected to propose regulations in July as part of the outpatient prospective payment system rule for CY 2017. (John Flink, WSHA federal lobbyist)


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