Here’s what you should know:
1. H.R. 6138 requires CMS to specify the criteria it uses to exclude certain ASC-based surgical procedures from Medicare coverage.
2. The bill also stipulates CMS can’t exclude a procedure because of a general concern the procedure can only be reported using an unlisted surgical procedure code.
3. If the bill becomes law, at least one ASC representative would have to be included on the 15-member advisory panel that reviews the Medicare prospective payment system for hospital outpatient departments and ASCs. The law currently requires all members to be hospital- or health system-employed.
4. The Ambulatory Surgery Center Association praised the House’s decision.
“This legislation will assure better communication between ASCs and government agencies that regulate us, leading to better decisions that will benefit Medicare beneficiaries requiring outpatient surgery,” said ASCA CEO William Prentice.
5. Skopos Labs, a technology company that uses artificial intelligence to predict risk and opportunity, projects the bill has a 29 percent chance of being enacted.
6. Sponsored by U.S. Congressman Devin Nunes, R-Calif., the legislation was introduced in the House June 19.
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