CMS Finalizes Hospital Outpatient Provider-Based Attestation Rule
In a client alert, Polsinelli reports that CMS finalized provider-based attestation requirements for off-campus hospital outpatient departments as part of the Nov. 4, 2026 Outpatient Prospective Payment Rule, implementing a requirement under Section 6225 of the Consolidated Appropriations Act, 2026. Hospitals must obtain a unique NPI for each off-campus physical location, update their 855A Medicare enrollment records, and submit attestations by Dec. 31, 2027, with no exemption for departments previously approved as provider-based. New outpatient departments beginning service after Jan. 1, 2028, must attest within the two-year period before their first service date. CMS will develop an electronic filing portal, has not yet released the standard attestation form, and will select a random sample of hospitals for extended review requiring supporting documentation within a generally 60-day window. Critical access hospitals are exempt, but certain other service lines such as laboratories and ambulance suppliers remain subject to the attestation requirement.