South Carolina Ambulatory Surgery Center Association

The Center for Medicare and Medicaid Services (CMS) will publish this week an interim-final regulation that restores to the ASC procedures list 95 of the 100 services that were proposed for deletion late last year.

The Medicare Payment Advisory Commission (MedPAC) issued two reports, both assembled by RAND, which are of great potential interest to the ambulatory surgery center community. The studies compare patient characteristics for several procedures across various ambulatory settings, cataract surgery, colonoscopy, and MRI of head, neck and brain in hospitals and ambulatory surgery centers. Click here for AAASC review.

In a June 16, 2004 letter to all members of Congress, AAASC President David Shapiro, MD identified the favorable MedPAC recommendation to eliminate the restrictive Medicare Procedure list and thus save Medicare and beneficiaries millions of dollars annually and provide broader choice to beneficiaries.

In May, 2004 AAASC surveyed state ASC associations to identify the most pressing legislative and regulatory issues impacting the growth of ASC. Here are the top issues:

Workers Comp payment reductions
Restrictions on physician ownership
Public reporting of ASC financial information
CON changes that restrict ASC growth

For more information about a specific state, review the information on state association websites or contact the leadership of the state association available at the AAASC website: http://www.aaasc.org/state/

AAASC has placed emphasis on the development and support of strong state ASC associations for many years. The state association is the first line of defense for state level issues. Fortunately many state associations are well positioned organizationally and are doing a great job representing the ASC industry as state legislative and egulatory issues arise.

AAASC Grassroots Advocacy Guide
This guide is intended to provide the ASC community with basic information about how to influence the government policies that affect our businesses and our patients.

http://www.aaasc.org/advocacy/grassroots/gr_guide.html

AHA Issues New Policy Paper Opposing “Niche Providers”
The American Hospital Association (AHA) issued a new policy paper during their meetings on Capitol Hill in Washington D.C. that “niche providers” are “undercutting the ability of community hospitals to continue to meet the needs of the broader community”. AHA includes ambulatory surgery centers as a niche provider.

AAASC President David Shapiro traveled to Washington , DC on April 8 for two important meetings with government study groups evaluating the Medicare ASC program. Dr. Shapiro was joined by AAASC Executive Director, Craig Jeffries, and Washington Counsel, Michael Romansky and Eric Zimmerman.

CMS Issues Memo on Overnight Stays

In a March 11 memorandum to state survey agency directors, CMS appears to be changing longstanding policy regarding overnight stays in ambulatory surgery centers. AAASC Washington Counsel has been in communication with CMS. CMS understands the questions we have raised about the statements in their memo that appear to restrict Medicare certified centers to performing only Medicare approved procedures. CMS is actively considering the need to correct the unintended changeand we will notify members of their resolution.

CMS Issues Guidance on Specialty Hospital Moratorium

The Centers for Medicare & Medicaid Services announced details of its plan to mplement a moratorium on physician investment in and referrals to certain specialty hospitals.

Medicare Payment Rates for ASC Services to be Dropped to pre-Oct.1, 03 Levels

Effective April 1, 2004, payment rates for the nine procedure groups will be as follows: Group 1 - $333,Group 2 - $446,Group 3 - $510, Group 4 - $630, Group 5 - $717, Group 6 - $676 plus $150 for IOL, Group 7 - $995, Group 8 - $823 plus $150 for IOL, Group 9 -$1,339 Please note that the rates listed above are national rates, and that actual payment rates will vary depending on your geographic location.
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The Medicare Payment Advisory Commission (MedPAC) approved three recommendations concerning Medicare payment to ambulatory surgery centers (ASCs) including two that were supported by AAASC. Learn More

CMS Issues Guidance on Specialty Hospital Moratorium

State Resources