CMS may claw back millions of dollars in payments after the agency denied reimbursement rate cut exemptions for hospitals’ off-campus outpatient facilities. CMS rejected more than 60% of the mid-build exceptions, which would preserve hospitals’ higher reimbursement rates if they had the documentation to prove their off-campus outpatient departments were being constructed when the Bipartisan Budget Act was passed in 2015. Without the exception, these facilities’ reimbursement rates drop to 40% of the full Outpatient Prospective Payments System rate; they would also be liable for overpayments issued starting Jan. 1, 2018, if they billed via OPPS.
Read the full article: Hospitals Get ‘Raw Deal’ as CMS Rejects Site-Neutral Pay Cut Exemptions //
Source: https://www.modernhealthcare.com/payment/hospitals-get-raw-deal-cms-rejects-site-neutral-pay-cut-exemptions