3 legislative changes impacting ASCs — Sept. 21, 2016

This was a big month for CMS as it imposed various changes, including delaying Medicare Access and CHIP Reauthorization Act to get providers ready for value-based care.

Here are three changes to note:

CMS publishes emergency preparedness final rule
CMS published its final rule for emergency preparedness on Sept. 16, scheduled to go into effect 60 days after publication. The final rule exempts ASCs from providing information about occupancy. Hospitals will continue to report on inpatient occupancy. ASCs are required to create a process to cooperate with local, regional, state and federal efforts for emergency preparedness in their community. The final rule also requires ASCs to document efforts to connect with emergency preparedness officials and collaborate in planning efforts when available.

CMS proposes moving 6 procedures off the inpatient only list in 2017
For 2017, CMS proposes moving four spine surgeries and two laryngopalsty procedures off the inpatient-only list. This is the first step toward achieving reimbursement from Medicare. The spine codes that would be removed from the inpatient only list include:
• Posterior non-segmental instrumentation: CPT 22840
• Posterior segmental instrumentation: CPT 22842
• Anterior instrumentation; two to three vertebral segments: CPT 22845
• Total disc arthroplasty anterior approach including discectomy with end plate preparation: CPT 22858

CMS allows for greater MACRA flexibility; physicians get more options and 'test' period
CMS has heard the concerns of many medical community members over the agency's MACRA and is giving providers more flexibility to avoid hefty penalties. The first option allows providers to submit "some data" to the Quality Payment Program after Jan. 1 and the second option allows providers to participate in the program for part of the calendar year. Under the third option, providers can submit Quality Payment Program information for the full calendar year and quality for a "modest" positive payment adjustment. The fourth option allows providers to Advanced Alternative Payment Model in 2017.

More articles on coding & billing:
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Wisconsin health officials ask to increase Medicaid spending by $452M: 3 things to know

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