SOS: Sustaining Outpatient Services Act

Key Points

• This bill, called the SOS Act, changes how Medicare pays for medical care at clinics that are owned by hospitals but located away from the main hospital building. These are often called 'off-campus' clinics.
• Currently, Medicare often pays these off-campus clinics at a lower rate than the main hospital. This bill would allow some of these clinics to get the higher hospital rate if they provide specialized services that are not used very often.
• To qualify for the higher pay, the total amount Medicare paid for that specific type of specialty care across the whole country must have been less than $2 million in the previous year. This targets niche medical services that might otherwise struggle to stay open.
• The goal is to help smaller or more specialized clinics stay in business, especially in areas where it might be hard for patients to find specific types of doctors. If passed, these new payment rules would start in 2027.
• While this helps keep local clinics open, it could lead to slightly higher costs for the Medicare program and higher out-of-pocket costs for some patients, as hospital-based rates are generally more expensive than standard doctor office rates.

Impact Analysis

Govbase has not yet run an impact analysis on this legislation.