Sec. 603. Treatment of off-campus outpatient departments of a provider
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Section 1833(t) of the Social Security Act ( 42 U.S.C. 1395l(t) ) is amended— in paragraph (1)(B)— in clause (iii), by striking but at the end; in clause (iv), by striking the period at the end and inserting ; and ; and by adding at the end the following new clause: does not include applicable items and services (as defined in subparagraph
(A)of paragraph (21)) that are furnished on or after January 1, 2017, by an off-campus outpatient department of a provider (as defined in subparagraph
(B)of such paragraph). ; and by adding at the end the following new paragraph: For purposes of paragraph (1)(B)(v) and this paragraph, the term applicable items and services means items and services other than items and services furnished by a dedicated emergency department (as defined in section 489.24(b) of title 42 of the Code of Federal Regulations). For purposes of paragraph (1)(B)(v) and this paragraph, subject to clause (ii), the term off-campus outpatient department of a provider means a department of a provider (as defined in section 413.65(a)(2) of title 42 of the Code of Federal Regulations, as in effect as of the date of the enactment of this paragraph) that is not located— on the campus (as defined in such section 413.65(a)(2)) of such provider; or within the distance (described in such definition of campus) from a remote location of a hospital facility (as defined in such section 413.65(a)(2)). For purposes of paragraph (1)(B)(v) and this paragraph, the term off-campus outpatient department of a provider shall not include a department of a provider (as so defined) that was billing under this subsection with respect to covered OPD services furnished prior to the date of the enactment of this paragraph. Payments for applicable items and services furnished by an off-campus outpatient department of a provider that are described in paragraph (1)(B)(v) shall be made under the applicable payment system under this part (other than under this subsection) if the requirements for such payment are otherwise met. Each hospital shall provide to the Secretary such information as the Secretary determines appropriate to implement this paragraph and paragraph (1)(B)(v) (which may include reporting of information on a hospital claim using a code or modifier and reporting information about off-campus outpatient departments of a provider on the enrollment form described in section 1866(j)). There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the following: The determination of the applicable items and services under subparagraph
(A)and applicable payment systems under subparagraph (C). The determination of whether a department of a provider meets the term described in subparagraph (B). Any information that hospitals are required to report pursuant to subparagraph (D). .
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Sec. 603
Treatment of off-campus outpatient departments of a provider
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