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1 bill on this topic
“HHS should check whether off-campus hospital outpatient departments qualify to bill as part of the hospital, including through site visits, remote audits, or other review methods the agency chooses.”
1 bill on this topic
“Off-campus hospital facilities should be able to have Medicare treat them as part of a main hospital for billing and payment even when they are more than 35 miles from that hospital.”
1 bill on this topic
“Medicare should pay one common rate for selected outpatient services done in hospital outpatient departments, surgery centers, or other HHS-approved outpatient settings, with HHS choosing at least 66 service groups each year and able to add more later.”
1 bill on this topic
“Medicare should pay certain off-campus hospital outpatient sites more like other outpatient facilities for covered services, and those sites should use separate identifiers and attestations so Medicare can track them.”
1 bill on this topic
“HHS should have one year to publicly explain how providers file the required off-campus outpatient department statements and how the agency reviews them, with hospitals, patients, and others allowed to comment first.”
1 bill on this topic
“Off-campus hospital outpatient departments should have to use their own Medicare billing IDs and confirm every two years that they qualify to be paid by Medicare as hospital outpatient departments.”
1 bill on this topic
“Hospitals should have to bill off-campus outpatient care using that site's own ID and a professional claim format, such as CMS-1500 or HIPAA X12 837P, for Medicare, Medicare Advantage, and private insurance claims.”
1 bill on this topic
“The billing ID and HHS filing system should cover hospital outpatient departments that are away from the main hospital campus and not close enough to a remote hospital location under Medicare distance rules.”
1 bill on this topic
“Each hospital-owned outpatient site away from the main hospital should have its own separate health identifier by January 1, 2026, so Medicare and insurers can tell where the care was provided.”
1 bill on this topic
“Medicare should gradually pay many off-campus hospital outpatient drug-administration services at rates closer to other care settings, with a four-year transition and extra time for rural and some safety-net hospitals.”
1 bill on this topic
“Medicare should treat more hospital-owned outpatient sites away from the main hospital, including off-campus emergency departments, as off-campus sites and let HHS move their payments closer to what Medicare pays for similar care outside a hospital.”
1 bill on this topic
“Each covered off-campus outpatient department should have to get its own Medicare billing identifier and use it on claims, instead of billing only under the hospital or provider's main identifier.”
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