The legislation aims to close reimbursement gaps between hospital outpatient departments and ASCs and increase CMS’ transparency when it comes to ASC data.
Now, almost a year later, the bill has remained stagnant in Congress, despite having bipartisan support.
Since being introduced in the House Energy and Commerce and Ways and Means committees, the legislation seems to have made few gains.
Here are six additional things to know about what the legislation would entail for practices and providers:
1. The bill would permanently align CMS’ update factors to move to a more complete alignment of the ASC and HOPD payment systems.
2. The bill would require quality data about ASCs and HOPDs to be readily available to the public in a consumer-friendly format.
3. The bill would designate one seat on the Advisory Panel on Hospital Outpatient Payment for an ASC representative.
4. The bill would require CMS to publish its rationale on declining to add any codes to the ASC covered procedures list.
5. The bill would cap a beneficiary’s copay for ASC procedures using the same framework as HOPD services.
6. The bill would prevent CMS from conducting a secondary scaling calculation. Instead, it would direct CMS to combine ASC and HOPD volume and calculate one outpatient weight scalar, making this provision budget neutral.
