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On Wednesday of this week, CMS issued the examination copy of the Outpatient Prospective Payment System (OPPS) final rule.  The official publication date is set for November 14, 2016. 

There are two section in the Federal Register entry that addresses the implementation of Section 603 of the Bipartisan Budget Act (BiBA) of 2015.  This involves Congressionally mandated payment changes for off-campus provider-based clinics and operations.  Interestingly enough, the provider-based rule (PBR) found at 42 CFR §413.65 is not materially changed.

The two sections appear in X. Nonrecurring Policy Changes:

  • Section X. A. – Implementation of Section 603 – This is a final rule, and
  • Section X.B. – Payment Rates for Non-Excepted Items/Services – This is an interim final rule.

The fact that the second section is an interim final rules simply means that we have 60 days to comment with comments due by Dec. 31, 2016.  Note, however, that this rule goes into effect on Jan. 1, 2017. 

As far as the many questions surrounding implementation of Section 603, CMS has softened their approach only a little.  The letters from Congress that were sent on Oct. 6, 2016 are not mentioned by CMS in this Federal Register entry nor do the directives of Congress in these letters followed to any great extent.

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Chuck Buck is the publisher of RACmonitor and the executive producer and program host of Monitor Mondays. 

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Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

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