CHA News Article

House Passes Helping Hospitals Improve Patient Care Act
CHA urges CMS to implement flexible regulations on Section 603

The House of Representatives passed H.R. 5273, the Helping Hospitals Improve Patient Care Act, yesterday evening. If signed into law, this legislation would extend the grandfather provision of the site-neutral payment policy established under the Bipartisan Budget Act of 2015 (BBA). As currently written, Section 603 of the BBA precludes hospital off-campus outpatient departments from receiving reimbursement under the outpatient prospective payment system if they were not billing on or after Nov. 2, 2015. H.R. 5273 would revise Section 603 to extend the grandfather provisions for services provided in federal fiscal year 2018 to some additional off-campus outpatient facilities that were under construction at the BBA’s enactment and submit a voluntary attestation to their Medicare administrative contractor prior to Dec. 31, 2016, or 60 days after enactment, whichever is later.

In addition, CHA submitted the attached comments to the Centers for Medicare & Medicaid Services (CMS) as the agency prepares for regulatory implementation of Section 603.

Following up to several meetings earlier this year, CHA notes that, while it supports H.R. 5273, additional regulatory flexibility is needed to meet the needs of California health care providers. For example, existing California law mandates that all hospitals be designed or retrofitted by 2030 to remain standing and operational in the event of major seismic activity. To comply with this law, many hospitals have elected to relocate outpatient services to off-campus facilities in order to continue to meet the needs of their communities while being good stewards of resources. These hospitals did so under the assumption of future reimbursement of services based on existing laws and regulations at the time of their decision.

Changes implemented under Section 603 of the BBA undermine the financial sense of these projects and disrupt long-term plans to comply with the Hospital Seismic Safety Act and provide critical outpatient services. CHA urges CMS to consider circumstances unique to California hospitals when implementing this challenging policy in rulemaking, to be released in early July.