The Medicare Payment Advisory Commission has responded to the proposed ASC payment rule by calling for all ASCs to report their costs, according to an ASCA Government Affairs Update.
MedPAC is an independent congressional agency that advises Congress and HHS on Medicare payment policies, patient access and quality of care. The Commission noted in a letter to CMS that it agrees the CPI-U update factor is inappropriate for ASC payments and may not reflect ASCs' cost structure. The letter went on to say that CMS should collect new cost data from surgery centers and use the data to determine whether an existing input price index is an appropriate update factor for ASC payments, or whether CMS should develop an ASC-specific market basket.
ASCA continues to oppose cost reporting due to the additional burden that may be experienced by surgery centers, as well as the unreliable nature of previously collected data. ASCA noted in comments on the proposed ASC payment rule that, "The delta between the ASC and HOPD conversion factor should be consistent from year to year, meaning that both systems are updated using a single inflation factor." ASCA believes that an ASC-specific market basket would not help to align payment systems with that of HOPDs.
The MedPAC letter also made the following recommendations and observations affecting ASCs:
• Asking CMS to develop and release its plans for publicizing ASC quality reporting data;
• Supporting the placement of the ASC payment update at 0.5 percent rather than the 1.3 percent recommended in the proposed payment rule;
• Calling ASC payments "at least adequate" in recent years;
• Supporting a CMS proposal to implement a "composite APC" rate for low-dose rate prostate brachytherapy, which is currently paid separately in ASCs but paid as a single rate when provided in the hospital outpatient prospective payment system;
• Recommending that HHS adopt a value-based purchasing program for ASCs with incentive payments derived from existing Medicare spending for ASC services; and
• Recommending measures related to surgical site infections, later hospital admissions and the patient experience be included in the ASC quality reporting program.
Related Articles on Coding, Billing and Collections:
Going From Out-of-Network to Participating Provider
Hospitals Should Bill Uninsured Patients at Discounted Rates
Meaningful Use Ruling Provides Clarity for Radiologists
MedPAC is an independent congressional agency that advises Congress and HHS on Medicare payment policies, patient access and quality of care. The Commission noted in a letter to CMS that it agrees the CPI-U update factor is inappropriate for ASC payments and may not reflect ASCs' cost structure. The letter went on to say that CMS should collect new cost data from surgery centers and use the data to determine whether an existing input price index is an appropriate update factor for ASC payments, or whether CMS should develop an ASC-specific market basket.
ASCA continues to oppose cost reporting due to the additional burden that may be experienced by surgery centers, as well as the unreliable nature of previously collected data. ASCA noted in comments on the proposed ASC payment rule that, "The delta between the ASC and HOPD conversion factor should be consistent from year to year, meaning that both systems are updated using a single inflation factor." ASCA believes that an ASC-specific market basket would not help to align payment systems with that of HOPDs.
The MedPAC letter also made the following recommendations and observations affecting ASCs:
• Asking CMS to develop and release its plans for publicizing ASC quality reporting data;
• Supporting the placement of the ASC payment update at 0.5 percent rather than the 1.3 percent recommended in the proposed payment rule;
• Calling ASC payments "at least adequate" in recent years;
• Supporting a CMS proposal to implement a "composite APC" rate for low-dose rate prostate brachytherapy, which is currently paid separately in ASCs but paid as a single rate when provided in the hospital outpatient prospective payment system;
• Recommending that HHS adopt a value-based purchasing program for ASCs with incentive payments derived from existing Medicare spending for ASC services; and
• Recommending measures related to surgical site infections, later hospital admissions and the patient experience be included in the ASC quality reporting program.
Related Articles on Coding, Billing and Collections:
Going From Out-of-Network to Participating Provider
Hospitals Should Bill Uninsured Patients at Discounted Rates
Meaningful Use Ruling Provides Clarity for Radiologists