CMS Implementation of Section 603 of the Bipartisan Budget Act: Implications for Provider-Based Clinics

CMS recently issued its proposed guidance implementing Section 603 of the Bipartisan Budget Act, which has been the subject of previous Morgan Lewis LawFlashes (found here and here).

The guidance addresses many of the questions hospitals have asked since the act’s passage last November. Some of the crucial points are as follows:

• Relocation of existing facilities will vitiate grandfathered status, absent CMS creating an exception for circumstances beyond a hospital’s control.
• Service lines can only be expanded within existing “clinical groups.”
• Hospitals will not be able to buy and sell hospital-based locations without removing grandfathered status, unless the entire hospital is sold with it.
• CMS will not be able to fully implement the statute in 2017 and proposes to have physicians bill for services in the interim.
• CMS is not blocking the creation of new provider-based departments, but will instead focus on creating appropriate billing mechanisms for services furnished in these spaces.

Join us for a thorough review of the proposal, which will cover these topics in greater detail and include a discussion of how the proposal will affect hospitals’ operations and participation in the 340B Program. We will also address suggested areas for comment.

For more information, please contact Michael T. Libor at +1.215.963.4717 or michael.t.libor@morganlewis.com.