Legislative issues for ASCs: What to expect over the next few years from ASCA CEO William Prentice

ASC CEO William Prentice discusses the key legislative updates for ASCs and the most important changes to look out for in the future.

Mr. Prentice is speaking on a panel titled "Washington Update" at the Becker's 15th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine on June 22 to 24, 2017 in Chicago. Click here to learn more and register.

Q: What are the biggest legislative issues for physicians and ASCs today?

William Prentice: The growing disparity between Medicare’s ASC and HOPD payment rates continues to be the biggest issue that physicians and ASCs face. In 2003, Medicare’s ASC payment rates averaged 83 percent of the HOPD rates, but ASC payment rates are now less than half of the HOPD rates. The formula Medicare uses to set ASC payment updates each year is illogical and unsustainable. Recently, with ASCA’s support, U.S. Representatives Devin Nunes (R-CA) and John Larson (D-CT) and a bipartisan group of cosponsors introduced the Ambulatory Surgical Center Quality and Access Act of 2017.

This bill would put a stop to the growing gap between ASC and HOPD payments. It would also:

• Require CMS to publish relevant quality data in a way that allows patients to compare quality across sites of service;
• Direct CMS to add an ASC representative to its Advisory Panel on Hospital Outpatient Payment because decisions made by the panel affect both HOPD and ASC facility fees and eligible procedures; and
• Require CMS to disclose which of six criteria triggers the exclusion of a procedure from the ASC approved list.

The ASC community must work together to support passage of this legislation.

Q: How can physicians and ASC leaders get involved to make a difference?

WP: If they sign up by April 14, ASC physicians and other leaders in the ASC community can join their colleagues and ASCA staff for National Advocacy Day events and visits to Capitol Hill that will be conducted during ASCA’s annual meeting this year, May 3–6, in Washington, D.C. To sign up or learn more about other ways they can get involved throughout the year, they should contact Danielle Kaster at ASCA (dkaster@ascassociation.org).

Q: What legislative changes should ASCs prepare for in the future?

WP: ASCs need to fight state and national policy proposals that would create regulatory burdens that fail to translate into meaningful improvements in the quality of care patients experience in ASCs, or that would limit the procedures ASCs are able to provide, or changes in state-run workers’ compensation programs that would limit patient access to ASCs.

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