A bipartisan group of 51 senators today urged the Centers for Medicare & Medicaid Services to provide flexibility in implementation of the Medicare payment reductions for new off-campus hospital outpatient departments under the 2015 Bipartisan Budget Act to protect patients’ access to care. Specifically, they said the “site-neutral” payment reductions under Section 603 of the Act should not affect existing off-campus HOPDs that relocate, rebuild, change ownership or types of services, and should not affect services provided by a dedicated emergency department. They also urged the agency’s regional offices to use the rule of “reasonable proximity” when evaluating on-campus status. The letter was spearheaded by Sens. Rob Portman (R-OH) and Charles Schumer (D-NY). Section 603 would apply to off-campus HOPDs that started billing Medicare for outpatient services under the outpatient prospective payment system on or after Nov. 2, 2015. CMS is expected to propose Section 603 regulations in July as part of the OPPS rule for calendar year 2017. Sponsors are still collecting signatures on a similar letter in the House; the current count is 233.