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New Compliance Guidelines for Off-Campus Provider-Based Departments Seeking Medicare Reimbursement

By Crystal Bloom, Joe Geraci, Alison Hollender, John Gramlich & Neha Khan on February 18, 2026
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A new law, the Consolidated Appropriations Act, went into effect on February 3, 2026, issuing new Medicare reimbursement guidelines for off-campus provider-based hospital outpatient departments (HOPDs). As of January 1, 2028, hospitals will be required to make certain operational changes to maintain OPPS reimbursement eligibility for their off-campus provider-based locations. These include such measures as obtaining a National Provider Identifier (NPI) separate from the hospitals’ NPI, and submitting an initial provider-based attestation demonstrating compliance with the requirements of 42 C.F.R. § 413.65.

To learn what other specific changes are needed, what qualifies as an Off-Campus Outpatient Department, and the significance of the new mandates, we urge hospitals to take a moment to read the full legal update.

Photo of Crystal Bloom Crystal Bloom

Crystal focuses her practice on Massachusetts and federal healthcare regulatory work, providing strategic regulatory advice to academic medical centers, community hospitals, psychiatric hospitals, ambulatory surgery centers, nursing facilities, assisted living residences, imaging providers, ambulance services, and hospice and home health agencies, among others.

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Photo of Joe Geraci Joe Geraci

Clients have come to rely on Joe to help resolve payment and reimbursement disputes and answer their compliance questions. He has created models to integrate physicians into larger healthcare systems and has guided home health agencies, physicians organizations, hospitals and health systems through…

Clients have come to rely on Joe to help resolve payment and reimbursement disputes and answer their compliance questions. He has created models to integrate physicians into larger healthcare systems and has guided home health agencies, physicians organizations, hospitals and health systems through the intricacies of mergers and acquisitions.

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Photo of Alison Hollender Alison Hollender

Alison knows the legal issues of healthcare transactions backwards and forwards—and she also knows the concerns and goals of the organizations involved. Before pursuing a law career, Alison worked at Cook Children’s Healthcare System and earned a master’s in healthcare administration. Both experiences…

Alison knows the legal issues of healthcare transactions backwards and forwards—and she also knows the concerns and goals of the organizations involved. Before pursuing a law career, Alison worked at Cook Children’s Healthcare System and earned a master’s in healthcare administration. Both experiences gave her an inside view of healthcare organizations.

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Photo of John Gramlich John Gramlich

With a strong background in regulatory law, John assists healthcare clients in ensuring compliance during transactions and throughout day-to-day operations.

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Photo of Neha Khan Neha Khan

Neha focuses on healthcare regulatory and transactional matters, supporting clients with legal and compliance needs in a changing industry.

Read more about Neha KhanEmail
  • Posted in:
    Health Care and Life Sciences
  • Blog:
    Healthcare Law Insights
  • Organization:
    Husch Blackwell LLP
  • Article: View Original Source

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