CHA News Article

President Signs 21st Century Cures Legislation
Includes provision to extend Section 603 grandfather date for off-campus PBDs

President Obama today signed the 21st Century Cures Act, placing the date of enactment as Dec. 13. The legislation includes a provision revising Section 603 of the Bipartisan Budget Act of 2015 to move the grandfather date for off-campus provider based departments (PBDs) under development from Nov. 2, 2015 to 60 days after the law is enacted, as long as the PBD was under development prior to Nov. 2, 2015. CHA expects the new deadline to be on or around Feb. 10, 2017, and will notify members as additional guidance is issued.

This provision would allow PBDs that narrowly missed the November 2015 deadline for furnishing covered outpatient department services, but already have opened or will soon open, to qualify for the higher outpatient prospective payment services (OPPS) rate. There are two tracks for which a provider may be eligible for full OPPS payments in either calendar year (CY) 2017 or 2018 and several steps in the process.

CHA expects additional guidance to be forthcoming from the Centers for Medicare & Medicaid Services (CMS) in the coming weeks to ensure that all providers can appropriately certify as required to receive CY 2018 OPPS payments. 

Hospitals should also be working quickly to complete the provider-based attestations that are required under this new provision. The legislation also requires CMS to audit all providers that fall under this newly established grandfather date. CHA encourages hospitals to consult with legal counsel as they proceed in navigating these provisions.  A more detailed summary of the entire 21st Century Cures legislation will be distributed through CHA News in the coming weeks. Notably, the mid-build language remained relatively unchanged from CHA-supported HR 5273, summarized here.

In addition, CHA reminds hospitals of the exceptions process for relocation, established in the CY 2017 OPPS final rule. That process is limited to extraordinary circumstances outside a hospital’s control — such as natural disasters, significant seismic building code requirements or significant public health and public safety issues — that necessitate moving to a new building, either temporarily or permanently, without losing its excepted status. More information on these provisions is available in CHA’s OPPS final rule summary. CMS Region IX is currently accepting for review and consideration relocation requests that fall under the purview of the exceptions process as outlined in the final rule. All requests should be sent via email to at the attention of Lisa Leong at the CMS Regional Office. Hospitals pursuing the relocation exception (now or in the future) are encouraged to contact Alyssa Keefe, CHA vice president federal regulatory affairs, at or (202) 488-4688.