The Centers for Medicare & Medicaid Services on Dec. 23 issued preliminary guidance clarifying the 21st Century Cures Act provisions that impact off-campus provider-based hospital outpatient departments that had concrete plans for construction when the Bipartisan Budget Act of 2015 was passed on Nov. 2, 2015. The Cures law extended the grandfather date for those facilities to qualify for payment under the outpatient prospective payment system, rather than at the lower “site-neutral” rate. The guidance clarifies that the hospital's Medicare Administrative Contractor must receive the required attestation and certification documents by Feb. 13, 2017 for the HOPD to be grandfathered in 2018, and the use of the new modifier for HOPDs that will be grandfathered in 2018 but not in 2017. On Dec. 28, CMS also issued sub-regulatory guidance on how hospitals can request from their CMS Regional Office a relocation exception for an excepted off-campus department of a provider due to an extraordinary circumstance. For more on the 21st Century Cures Act, see the recent AHA Legislative Advisory.