What HCFA was taking away from some hospitals with outpatient clinics, the lame ducks in Washington gave back, at least temporarily.
The budget bill that Congress passed and President Clinton signed last month included a two-year transitional period for HCFA's provider-based rule, agency officials told MODERN HEALTHCARE.
The rule, which complements the final outpatient PPS regulations that HCFA issued, governs Medicare payments to hospital-owned outpatient clinics and will go into effect on Jan. 10.
At that time, Medicare would continue to pay on-site hospital clinics at a higher rate but start paying off-site hospital clinics at the same lower rate paid to nonhospital clinics.
But after intense lobbying from hospital groups, Congress agreed to continue paying the higher on-site rate to off-site hospital clinics that were reimbursed by HCFA at provider-based rates through Sept. 30, 2002, with some minor strings attached. New hospital-owned clinics opened after Oct. 1, 2000, will be subject to the rule.
To continue to receive those higher on-site rates, off-site hospital clinics must adhere to hospital life-safety codes and federal laws against patient dumping.
Language in the budget law also makes it easier for off-site hospital clinics to qualify for higher rates as on-site hospital clinics. The law allows any off-site clinic to be considered on-site if it's located within 35 miles of the hospital that owns it.
The final outpatient PPS regulations used a complex formula involving hospital, clinic and patient ZIP codes to determine whether a clinic qualified.
Medicare's outpatient PPS system went into effect last Aug. 1.
Separately, another provision of the budget law increases funding for health services provided through telemedicine.
Telemedicine uses video and Internet technology to improve rural residents' access to distant specialists. The budget law expands the definition of communities that qualify for reimbursement of telemedicine services to all nonmetropolitan areas, and expands the number and types of telemedicine services that qualify for funding.