PLACE Act of 2019

Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019

This bill requires the Centers for Medicare & Medicaid Services (CMS) to treat certain clinical services that are furnished by an excepted off-campus outpatient department of a provider (i.e., a department that would be considered an off-campus outpatient department but for certain statutory exceptions) during a specified period as though such services were provided on-campus for purposes of Medicare payment. (In November 2018, the CMS issued regulations that applied a lower Medicare payment rate for such services.)

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2552 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 2552

To direct the Secretary of Health and Human Services to prevent certain 
payment reductions for clinic visit services furnished at excepted off-
campus outpatient departments of a provider under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 7, 2019

  Mr. Kilmer (for himself and Ms. Stefanik) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To direct the Secretary of Health and Human Services to prevent certain 
payment reductions for clinic visit services furnished at excepted off-
campus outpatient departments of a provider under the Medicare program.

    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 ``Protecting Local Access to Care for 
Everyone Act of 2019'' or the ``PLACE Act of 2019''.

SEC. 2. PREVENTING CERTAIN PAYMENT REDUCTIONS FOR CLINIC VISIT SERVICES 
              FURNISHED AT EXCEPTED OFF-CAMPUS OUTPATIENT DEPARTMENTS 
              OF A PROVIDER UNDER THE MEDICARE PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall, 
for purposes of payment under part B of title XVIII of the Social 
Security Act (42 U.S.C. 1395j et seq.) for clinic visit services (as 
defined in subsection (c)) furnished during the period beginning on 
January 1, 2019, and ending on December 31, 2020, by an applicable 
provider (as defined in such subsection), treat such services as if 
such services had been furnished by a department of a provider located 
on the campus (as defined in section 413.65(a)(2) of title 42, Code of 
Federal Regulations (or any successor regulation)) of such provider.
    (b) Reimbursement.--In the case of such clinic visit services 
furnished during the period described in subsection (a) by such an 
applicable provider for which payment has already been made under such 
part B as of the date of the enactment of this Act, the Secretary of 
Health and Human Services shall promptly reimburse such provider in an 
amount equal to the difference between the payment for such services 
under subsection (a) and the amount actually paid for such services.
    (c) Definitions.--In this section:
            (1) Applicable provider.--The term ``applicable provider'' 
        means a department of a provider that would be an off-campus 
        outpatient department of a provider (as defined in section 
        1833(t)(21)(B) of the Social Security Act (42 U.S.C. 
        1395l(t)(21)(B)) but for the application of clause (ii) or (iv) 
        of such section.
            (2) Clinic visit services.--The term ``clinic visit 
        services'' means those services identified by Healthcare Common 
        Procedure Coding System code G0463 (or a successor code).
            (3) Department of a provider.--The term ``department of a 
        provider'' has the meaning given such term in section 
        413.65(a)(2) of title 42, Code of Federal Regulations, as in 
        effect as of the date of the enactment of this Act.
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