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7 legislative changes impacting ASCs — July 2018

Here are seven legislative issues impacting ASCs:

CMS seeking feedback on Stark Law revisions
CMS is seeking recommendations on how to reduce regulatory burdens created by Stark Laws. Stark Law and anti-kickback statutes create obstacles to developing alternative payment models suited for independent specialty practices, according to Large Urology Group Practice Association President Neal Shore, MD. He said certain provisions create a competitive advantage for larger hospital systems, threatening the viability of independent practices.

State court denies Surgical Care Affiliates' fee schedule challenge
On April 6, the North Carolina Supreme Court denied Birmingham, Ala.-based Surgical Care Affiliates' request for a review of ASC provisions in the worker's compensation fee schedule. Rule 11 NCAC 23J .0103, which went into effect April 1, 2015, will remain in effect for ASCs.

Rhode Island passes 1st surgical smoke law
Rhode Island passed legislation requiring all licensed hospitals and ASCs to implement smoke evacuation system policies for surgical procedures generating plume. It is the first state to do so. Facilities have 90 days to notify the state's health department they've adopted policies addressing surgical smoke ventilation.

Alabama publishes ASC workers' compensation fee schedule for 2018
The Alabama Workers' Compensation Division published updates to its ASC fee schedule. The fee schedule applies to more than 30 centers in Alabama. More than a dozen centers agreed to a maximum reimbursement of cost plus 10 percent for hardware, implants and prosthesis used in cases costing more than $200.00.

CMS freezes $10.4B in risk adjustment payments
CMS will not make $10.4 billion in payments that were due to insurers under the ACA. The payments were required under the ACA's "risk adjustment program" to offset costs for insurers whose customers need expensive medical services. They were due to insurers in the fall for expenses from 2017. America's Health Insurance Plans President Matt Eyles said the decision could create market uncertainty as insurers decide whether to participate in ACA marketplaces for 2019 and increase premiums for many health plans.

Pennsylvania ASC coalition slaps down 100K tax burden
Pennsylvania's new $32.7 billion budget does not include a proposed tax on ASC revenues, marking a victory for the coalition of surgery center advocates that opposed the tax. Pennsylvania Gov. Tom Wolf, D, had proposed a 2.81 percent tax on net patient revenue for ASCs and endoscopy centers.

House to vote on medical device tax repeal
The House plans to vote in late July on legislation to repeal the ACA's medical device tax. The 2.3 percent tax on sales of medical devices was enacted to help pay for the ACA. The tax's implementation has been delayed several times, but it's set to go into effect in 2020.

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