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What ASCs can expect from CMS in the next year

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The federal government was relatively friendly to ASCs during the Trump administration, with CMS paying for more types of surgery in ASCs and HHS loosening regulations on how centers could practice during the pandemic.

How will things change during the Biden administration? It's still too early to tell, said Bill Prentice, CEO of the Ambulatory Surgery Center Association, at the Becker's 18th Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference on June 8. He talked about where CMS could be headed and the potential for a public option, among other issues being debated on Capitol Hill.

CMS typically releases its proposed final rules for the following year in July, but the Biden administration's picks for HHS and CMS administrator were only recently confirmed. As a result, Mr. Prentice said he doesn't anticipate muc change in policy from the past few years.

"Our expectation is that the payment rule this year will be pretty benign," Mr. Prentice said. "There won't be any grand policy changes because quite frankly I don't think there's been time to implement any. I think we're going to be looking at probably next July before we really get a sense of whether this administration wants to make any fundamental changes with the way the ASC program operates within Medicare and Medicaid."

When it comes to payer trends, Mr. Prentice said there is more movement on the commercial side to develop policies driving outpatient surgeries to ASCs versus hospitals and hospital outpatient departments. This trend gives him hope that the federal government will make similar moves in the future.

"The drivers of the ASC model are the efficiency and quality they can bring to the healthcare market," Mr. Prentice said. "I think the secret sauce is physician ownership. Physicians having control over the entire physical environment of the surgery center has led to an efficiency that improves our healthcare system, and we would love to see the government at the state and federal level recognize that more and enact policies to spur on more ASC growth."

Mr. Prentice also mentioned shoring up the Affordable Care Act as a top priority of the Biden administration. He also spoke about the potential for a public option with a Democrat-controlled Congress.

"At the end of the day, I wouldn't hold my breath and expect that we're going to see anything like a public option this year, but I think if the Democrats can maintain control, particularly through the midterm elections, I could see something being enacted before the end of the president's first term," he said.

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