On December 7, 2016, the Senate passed the 21st Century Cures Act (“Cures Act”), which revised Section 603 of the Bipartisan Budget Act of 2015 (“Section 603”) to provide an exception for off-campus provider-based departments (“PBDs”) that were mid-build or under development prior to November 2, 2015. The Cures Act was signed into law by President Obama on December 13, 2016.
On January 1, 2017, CMS issued Relocation Exception Request Guidance regarding the Application Review Process, Suggested Minimum Information the hospitals should submit to CMS and the appropriate Regional Office the exception request should be made. This was released by CMS on its website.
To meet the definition of “mid-build,” the hospital would be required to establish it had a binding written agreement with an outside unrelated party for the actual construction of such department before November 2, 2015. Additionally, to qualify as “mid-build,” each off-campus PBD will be required to submit a certification from the provider’s chief executive officer/chief operating officer prior to 60 days after the date of enactment of the Cures Act legislation. The certification must state that the off-campus PBD meets the definition of mid-build. If the hospital receives approval under this exception, hospitals would be eligible to receive full OPPS payments.
The guidance provides information on how hospitals can qualify for the relocation exception and request CMS approval for those off-campus departments under the Cures Act upon a demonstration of extraordinary circumstances outside of the hospital’s control, such as natural disasters, significant seismic building code requirements or significant public health and public safety issues. CMS states that exceptions to the relocation policy will be evaluated on a case-by-case basis by the appropriate CMS Regional Office.
Practical Takeaways
For an off-campus department of a provider that relocated due to an extraordinary circumstance between November 2, 2015 and December 31, 2016, hospitals should submit a written relocation exception request with supporting documentation via email to their Regional Office no later than January 31, 2017.
For a relocation occurring on January 1, 2017 or later, hospitals should submit a relocation exception request no later than 30 days after the extraordinary circumstance occurred. The applicable Regional Office will communicate the effective date for an approved relocation request, which will be the later of the date the relocation request was made or the date of the relocation.
If you have any questions, or if you would like additional information about this topic, please contact Cliff Beyler at (317) 977-1441 or cbeyler@wp.hallrender.com.
