Section 6225 of the Consolidated Appropriations Act of 2026 (CAA 2026), enacted on February 3, 2026, fundamentally changes Medicare's treatment of hospital off-campus provider-based departments. Beginning January 1, 2028, each off-campus provider-based location must satisfy two new statutory prerequisites—obtaining a distinct organizational National Provider Identifier (NPI) and filing a current provider-based attestation—or face loss of Medicare payment eligibility.