Hospitals are ever increasingly establishing provider-based clinics of all types. The Provider-Based Rule (PBR) is complex and there are definite ambiguities. While hospitals can enjoy increased revenues from provider-based clinics, compliance with all the rules and regulations is challenging.
Format : LIVE WEBINAR
Presenter : Duane C. Abbey, PhD
Event Date : 02/28/2019
Time: Â 1 pm ET | 12 pm CT | 11 am MT | 10 am PT
Hospitals are ever increasingly establishing provider-based clinics of all types. The Provider-Based Rule (PBR) is complex and there are definite ambiguities. While hospitals can enjoy increased revenues from provider-based clinics, compliance with all the rules and regulations is challenging. Recent changes in the supervisory requirements for provider-based operations have created confusion and new compliance challenges.
To briefly review the Provider-Based Rule (PBR).
To review the criteria that must be achieved for clinics to be recognized as provider-based.
To update the current status of changes in payment to off-campus provider-based clinics as provided through Section 603 of the BBA 2015.
To review the further changes made by the 21st Century Cures Act.
To briefly update critical physician supervisory rule changes.
To discuss documentation requirements relative to physician supervision requirements.
To appreciate the increase in reimbursement for provider-based clinics.
To understand the attestation and request for determination processes.
To understand the need for updating and the documentation of organizational structuring relative to the PBR.
To understand the review/audit process for assessing current and/or potential provider-based situations.
To understand the economic benefits versus the compliance requirements.
To appreciate the relationship of PBR relative to the Conditions for Payment, Conditions of Participation and gaining billing privileges.
To understand the regulatory pressures for reducing reimbursement for provider-based clinics.
To appreciate the evolving guidance that is being provided by CMS and/or the Regional Offices.
To work through several case studies.
Review of the Provider-Based Rule (PBR)
Economic Advantages of Provider-Based Status
Current Activity Surrounding Medicare Payment for Provider-Based Clinics
Provider-Based Requirements â Special Issues
Physician Supervisory Requirements
Provider-Based Clinics â The Future
Case Studies â Provider Based Clinics
Recognition by Non-Medicare Third-Party Payers
Very Brief History of Provider-Based Clinics
Costs for Provider-Based Status
CMS Data Gathering of Cost for Off-Campus Provider-Based Clinics/Operations
Section 603, BBA 2015 Changes Starting January 1, 2017
Section 16001, 21st Century Cures Act
CY2018 & CY2019 OPPS Federal Register â Policy Changes
CY2018 & CY2019 MPFS Federal Register â Payment Processes
POS 19/22 Indicators â 1500CY2018 & CY2019 OPPS Federal Register â Policy Change
Payment Process or Non-Excepted Clinics
Definition of âNewâ Relative to BBA 2015
Mid-Build Exception for Grandfathering
Other Regional Office Issues
Recent Changes and Clarifications
Relationship to Physician Incident-To Billing
Data Gathering and Assessment
Attestations and Requests for Determination
Canât Listen Live?
No problem. You can get access to On-Demand webinar. Use it as a training tool at your convenience.
For more information you can reach out to below contact:
Toll-Free No: 1-302-444-0162
Email: [email protected]