Sec. 16001. CONTINUING MEDICARE PAYMENT UNDER HOPD PROSPECTIVE PAYMENT SYSTEM FOR SERVICES FURNISHED BY MID-BUILD OFF-CAMPUS OUTPATIENT DEPARTMENTS OF PROVIDERS
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## SEC. 16001 CONTINUING MEDICARE PAYMENT UNDER HOPD PROSPECTIVE PAYMENT SYSTEM FOR SERVICES FURNISHED BY MID-BUILD OFF-CAMPUS OUTPATIENT DEPARTMENTS OF PROVIDERS ###
(a)In General Section 1833(t)(21) of the Social Security Act (42 U.S.C. 1395l(t)(21)) is amended— ####
(1)in subparagraph (B)— #####
(A)in clause (i), by striking “clause (ii)” and inserting “the subsequent provisions of this subparagraph”; and #####
(B)by adding at the end the following new clauses: > > ###### “(iii) Deemed treatment for 2017 > > For purposes of applying clause
(ii)with respect to applicable items and services furnished during 2017, a department of a provider (as so defined) not described in such clause is deemed to be billing under this subsection with respect to covered OPD services furnished prior to November 2, 2015, if the Secretary received from the provider prior to December 2, 2015, an attestation (pursuant to section 413.65(b)(3) of title 42 of the Code of Federal Regulations) that such department was a department of a provider (as so defined). > > > ###### “(iv) Alternative exception beginning with 2018 > > For purposes of paragraph (1)(B)(v) and this paragraph with respect to applicable items and services furnished during 2018 or a subsequent year, the term ‘off-campus outpatient department of a provider’ also shall not include a department of a provider (as so defined) that is not described in clause
(ii)if— > > > ###### “(I) > > the Secretary receives from the provider an attestation (pursuant to such section 413.65(b)(3)) not later than December 31, 2016 (or, if later, 60 days after the date of the enactment of this clause), that such department met the requirements of a department of a provider specified in section 413.65 of title 42 of the Code of Federal Regulations; > > > ###### “(II) > > the provider includes such department as part of the provider on its enrollment form in accordance with the enrollment process under section 1866(j); and > > > ###### “(III) > > the department met the mid-build requirement of clause
(v)and the Secretary receives, not later than 60 days after the date of the enactment of this clause, from the chief executive officer or chief operating officer of the provider a written certification that the department met such requirement. > > > ###### “(v) Mid-build requirement described > > The mid-build requirement of this clause is, with respect to a department of a provider, that before November 2, 2015, the provider had a binding written agreement with an outside unrelated party for the actual construction of such department. > > > ###### “(vii) Audit > > Not later than December 31, 2018, the Secretary shall audit the compliance with requirements of clause
(iv)with respect to each department of a provider to which such clause applies. If the Secretary finds as a result of an audit under this clause that the applicable requirements were not met with respect to such department, the department shall not be excluded from the term ‘off-campus outpatient department of a provider’ under such clause. > > > ###### “(viii) Implementation > > For purposes of implementing clauses
(iii)through (vii): > > > ###### “(I) > > Notwithstanding any other provision of law, the Secretary may implement such clauses by program instruction or otherwise. > > > ###### “(II) > > Subchapter I of chapter 35 of title 44, United States Code, shall not apply. > > > ###### “(III) > > For purposes of carrying out this subparagraph with respect to clauses
(iii)and
(iv)(and clause
(vii)insofar as it relates to clause (iv)), $10,000,000 shall be available from the Federal Supplementary Medical Insurance Trust Fund under section 1841, to remain available until December 31, 2018.” > ; and ####
(2)in subparagraph (E), by adding at the end the following new clause: > > ###### “(iv) > > The determination of an audit under subparagraph (B)(vii).” > . ###
(b)Effective Date **[**[42 U.S.C. 1395l note](/us/usc/t42/s1395l)**]** The amendments made by this section shall be effective as if included in the enactment of section 603 of the Bipartisan Budget Act of 2015 (Public Law 114-74).
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Sec. 16001
CONTINUING MEDICARE PAYMENT UNDER HOPD PROSPECTIVE PAYMENT SYSTEM FOR SERVICES FURNISHED BY MID-BUILD OFF-CAMPUS OUTPATIENT DEPARTMENTS OF PROVIDERS
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