Hospitals must file compliance attestations and obtain unique NPIs for all off-campus HOPDs by January 1, 2028, under the Congressional funding bill passed yesterday.
Congress has considered implementing these requirements for several years, and the directive comes with an additional $20 million for CMS in appropriations to enforce the provisions. Congress has seemingly mandated that even entities with previously approved voluntary attestations will need to file again by January 1, 2028. Hospitals will then need to re-attest based on timeframes to be established by CMS. Medicare will prohibit payment for services within these HOPDs for any hospitals failing to comply.
Given the impact of off-campus HOPDs on Medicare reimbursement and 340B drug pricing program eligibility, Advis recommends starting compliance assessments now.
While CMS will likely release additional guidance on the mandatory attestation process in the CY27 OPPS/ASC Proposed Rule, typically released in early July, there is an existing framework for voluntary provider-based attestations that CMS can easily leverage to meet Congress’s directives. Historically, these filings have included extensive exhibits and supporting documentation, and the preparation process has required careful vetting of these materials and mitigation of compliance risks.
Advis has filed and achieved CMS approval for countless attestations. Our team of national experts is ready to assist you with this process, whether it’s being a resource, providing strategic advice, or completing these attestations for your organization.
We’ve also summarized other notable healthcare regulatory provisions of the funding bill below:
- Telehealth flexibilities were extended through the end of 2027.
- Congress extended Hospital-at-Home flexibilities for another 5 years, pushing the expiration date to September 30, 2030.
- The bill delays Medicaid disproportionate share hospital (DSH) payment cuts until 2029
- Extends increased inpatient payment adjustment for low-volume hospitals through FY 2028
- Extends the existing add-on payments for ground ambulance services through January 1, 2028
- Extends the work geographic index floor (which prevents physician payment decreases in certain areas) until January 1, 2027
- Provides a 3.1% incentive payment in 2028 for providers participating in eligible alternative payment models.
- Additional public health and research and grant funding with increases to the following programs:
- Community Health Centers (CHCs): $4.6 billion for FY 2026, plus roughly $1.2 billion in bridge funding through Dec. 31, 2026.
- Health Workforce: $350 million for the National Health Service Corps (NHSC) and $225 million for Teaching Health Centers Graduate Medical Education (THCGME).
- Maternal and Child Health: $1.2 Billion for the Maternal and Child Health Bureau.
- Rural Health & Infrastructure: $418 million for rural hospitals at risk of closure and residency spots
While Congress voted to largely maintain existing programs through HHS and CMS, the bill notably still does not extend ACA subsidies.
For more information on legislative action and the potential impact to your organization, please contact Advis.
Published February 3, 2026
