[Congressional Record (Bound Edition), Volume 162 (2016), Part 12]
[Senate]
[Pages 15999-16000]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        21ST CENTURY CURES BILL

  Mr. RUBIO. Mr. President, I am pleased to see that the 21st Century 
Cures Act will fix one of the issues associated with payments for 
hospital outpatient departments that arose from the Bipartisan Budget 
Act of 2015. You will recall that section 603 of that act changed the 
way these departments will be reimbursed by Medicare in the future. 
Hospital outpatient departments that were billing Medicare prior to 
November 2, 2015, however, were exempted from these reduced payments.
  We have heard from a number of hospitals in Florida that were in the 
middle of developing hospital outpatient departments when the new law 
went into effect. They had made substantial investments in these new 
departments under the assumption that Medicare

[[Page 16000]]

would pay them just as it had been doing for years. I am pleased to see 
that the 21st Century Cures Act will permit hospitals that were in the 
process of developing outpatient departments to be reimbursed under the 
previous payment system.
  In my State, Jackson Health System, a large public hospital which is 
known throughout the world for its high-quality healthcare and its 
value as a public hospital in our community, was in the process of 
building four new outpatient departments for patients in the Miami-Dade 
County area when the new law was passed. They had executed binding 
leases on three of the departments, constructed facilities, and 
finalized contracts for architectural and engineering reviews on 
several of the facilities. They had gone through a long process of 
getting the necessary approvals and financing from the county and State 
governments.
  It is obvious that all four of Jackson's outpatient facilities meet 
the ``mid-build'' exception contained in section 16001 of the 21st 
Century Cures Act. The actual construction of these facilities was 
complete, and Jackson was in the process of securing all the necessary 
requirements for the renovations of these facilities when the new law 
was passed on November 2, 2015. The Centers for Medicare and Medicaid 
Services, CMS, clearly agreed when they issued provider numbers to all 
four new outpatient departments in September and October 2015. For 
hospitals like Jackson, the subsequent change in the law essentially 
changed the rules in the middle of the game. I urge CMS to work with 
all hospitals in similar situations.
  I am very pleased that the 21st Century Cures Act will provide relief 
to the Jackson Health System and hospitals like it that had made these 
investments in future outpatient healthcare departments prior to the 
Bipartisan Budget Act of 2015.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

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