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CMS gives some relief on off-campus reimbursement

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CMS, in a final rule that changes how providers with off-campus facilities are reimbursed, has grandfathered in some hospitals that have had to relocate their facilities because of natural disasters.

The final rule  stops paying  for care at hospital off-campus facilities at the same rate as at hospital-based outpatient departments if they started billing Medicare after Nov. 2, 2015.

Modern Healthcare notes:  “The change will make it difficult for health systems to recoup capital or operational costs for off-site facilities, even though they are responsible for continuing to equip and maintain the off-campus offices.”

There has been concern that the draft rule did not protect reimbursements  for work done at recently relocated off-site facilities that had to be moved because of  environmental issues, such as being on an earthquake fault line or a flood plain; having a lease expire, or becoming too small because of population shifts and increased patient loads.

So  CMS is allowing exceptions for extraordinary circumstances while warning that exceptions will be rare.

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