Patient Parity Protection Act of 2021
Bill: H.R.4263 | Sponsor: Rep. Gottheimer, Josh (D-NJ)
Policy area: Health

Summary:
Patient Parity Protection Act of 2021
This bill allows certain off-campus departments of providers to be included in the Medicare prospective payment system for hospital outpatient department services. Providers must attest that the department was previously considered on-campus or otherwise met applicable requirements, but is now off-campus due to the provider's forced relocation to meet patient needs.

To amend title XVIII of the Social Security Act to provide for an 
exception to the definition of an off-campus outpatient department of a 
   provider under the Medicare program for certain departments of a 
      provider if such provider was forced to relocate its campus.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patient Parity Protection Act of 
2021''.

SEC. 2. PROVIDING FOR AN EXCEPTION TO THE DEFINITION OF AN OFF-CAMPUS 
              OUTPATIENT DEPARTMENT OF A PROVIDER UNDER THE MEDICARE 
              PROGRAM TO ACCOUNT FOR FORCED CAMPUS RELOCATIONS OF 
              PROVIDERS.

    Section 1833(t)(21)(B) of the Social Security Act (42 U.S.C. 
1395l(t)(21)(B)) is amended by adding at the end the following new 
clause:
                            ``(ix) Exception for on-campus departments 
                        converted to off-campus departments.--For 
                        purposes of paragraph (1)(B)(v) and this 
                        paragraph and with respect to applicable items 
                        and services furnished during 2020 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 section 413.65(b)(3) of title 42, 
                                Code of Federal Regulations) not later 
                                than 60 days after the date of the 
                                enactment of this clause that such 
                                department met the requirements of a 
                                department of a provider 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)) 
                                specified in such section 413.65 as of 
                                November 1, 2015;
                                    ``(II) such provider was forced to 
                                relocate its campus (as so defined) 
                                from the location of such campus as of 
                                November 1, 2015, due to such campus' 
                                inability to meet the health care needs 
                                of such provider's patient population, 
                                as demonstrated by a certificate of 
                                need or equivalent approval document 
                                issued by the State agency licensing 
                                such provider at such location; and
                                    ``(III) the department continues to 
                                furnish applicable items and services 
                                at the same address at which such items 
                                and services were furnished as of 
                                November 1, 2015.''.
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