The New Era of Reimbursement Opportunities

During 2018 CMS continued to press its site-neutral agenda relative to hospital based (aka provider based) services.  It initiated a move toward site neutral payment for E&M services, regardless of venue and expanded the reduction in Medicare payment for 340B covered drugs to include non-grandfathered/excepted provider based sites.  This presentation will include an update on these and other related changes, as well as address CMS enforcement activity around the provider based rules and the definition of a hospital in the mixed use context.   The presentation will also cover urban, rural and wage index reclassification opportunities created by recent litigation and regulatory changes.  All of these topics will be addressed in the context of how these changes are impacting hospital and health system operational strategies & tactics, including: hospitals within hospitals & satellite units, multi-campus hospitals & remote locations,  micro hospitals, free standing EDs, grandfathered and new provider based sites, and 340B optimization.