Health Care Today | Health Law Blog

On December 28, 2021, directors from the Quality, Safety and Oversight Group at The Centers for Medicare and Medicaid Services (CMS) released a memorandum (QSO-22-07-ALL) outlining its procedures for surveying compliance under its November 5, 2021, Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule (IFR). The memorandum references various attachments for specific provider types which supplement and are intended to be used in conjunction with it.

In 2019, the Centers for Medicare and Medicaid Services (CMS) issued draft guidance on hospital co-location (when hospitals share space and resources with other health care entities). We previously summarized that draft guidance here. On November 12, 2021, CMS issued its final guidance and — surprise! — it changed quite a bit.

As the virus continues to spread, U.S. hospitals will likely see increasing numbers of potential cases of COVID-19 in their emergency departments. Hospitals are obligated under the Emergency Medical Treatment and Labor Act (EMTALA) to provide these individuals with certain examinations and, if necessary, stabilizing treatment or transfer. This raises a host of issues for hospitals that receive these individuals for care, including capacity and resource concerns, and the risks these individuals may pose to medical personnel and other people in the vicinity, including other patients and staff.

Many hospitals share space with other health care entities. Despite this, the Centers for Medicare & Medicaid Services (CMS) has given mixed signals — and never issued formal guidance — concerning the permissibility of shared spaces under the Medicare Conditions of Participation (CoP). This has created great confusion and uncertainty for hospitals as they try to meet the challenges of a rapidly changing health care system.

That’s all about to change!

The Centers for Medicare & Medicaid Services (CMS) has found that hospitals are increasingly operating “off-campus, outpatient, provider-based” departments. Services provided at these off-campus facilities are required to be billed using the off-campus facility’s address so that payment can be accurately made under the Medicare Physician Fee Schedule (MPFS) or the Outpatient Prospective Payment System (OPPS).