SOS: Sustaining Outpatient Services Act

This bill would allow Medicare to pay for certain items and services provided at off-campus hospital outpatient departments through the hospital outpatient prospective payment system. This payment structure would apply specifically to services where total payments to physician specialists under the Medicare physician fee schedule did not exceed $2 million during the preceding year.

This bill affects off-campus hospital outpatient departments that furnish specific items and services to Medicare beneficiaries. It also impacts physician specialists whose total Medicare fee schedule payments for those items and services did not exceed $2 million in the preceding year. Additionally, the legislation affects the Medicare prospective payment system by modifying how these specific outpatient services are reimbursed.

• Medicare payment for off-campus outpatient services. The bill authorizes payments under the Medicare prospective payment system for specific items and services provided at off-campus hospital outpatient departments.
• Eligibility threshold for physician specialist payments. Payment eligibility is limited to items and services where total payments to physician specialists under the Medicare physician fee schedule remained at or below $2 million during the preceding year.

The bill modifies the Medicare prospective payment system for hospital outpatient department services by allowing payments for certain items and services furnished at off-campus locations. It also establishes a payment threshold based on previous year expenditures under the Medicare physician fee schedule.

The bill aims to authorize Medicare prospective payment system coverage for specific items and services provided at off-campus hospital outpatient departments. It focuses on maintaining outpatient services by allowing these payments for services where total physician specialist reimbursements remained below $2 million in the preceding year.