10 legislative updates for ambulatory surgery centers — Feb. 24

Here are 10 recent legislative updates for ambulatory surgery centers.

A Pennsylvania senator has introduced legislation that would limit the insurance companies' retroactive reimbursement denial so payers aren't able to take away reimbursement 12 months after paying the initial claim.

 

The Centers for Medicare and Medicaid Services extended their deadline to finalize a rule under the Affordable Care Act that requires providers to report and return overpayments to Medicare. The extension is for one year, and the proposed rule would look back at paid claims for the past 10 years for overpayments.

 

Ambulatory surgery centers must report healthcare personnel influenza vaccination summary data to the National Healthcare Safety Network by May 15 to qualify for the Medicare ASC Quality Reporting Program. This is one of 10 quality measures.

 

The Supreme Court is ruling on King v. Burwell, which challenges healthcare reform's authorization of federal tax credits for low- and middle-income individuals who purchase insurance on the exchanges. Eliminating the tax credits would mean more uncompensated care with less spending on hospitals, physicians and pharmaceuticals.

 

CMS revised guidance on the State Operations Manual for ASC surveyors, clarifying the physician discharge order requirements for ASCs. Operating physicians are able to write a discharge order indicating the patient may be "discharged when stable" instead of requiring patients to leave the ASC within 15 minutes to 30 minutes of the time physicians signed the discharge order.

 

President Barack Obama's 2016 budget was released earlier this year and aims to save $423 billion from Medicare from 2016 and 2025. The budget would repeal the sustainable growth rate and lower off-campus HOPD rates to physician fee schedule or ambulatory surgery center rates. The rate change is estimated to have a $29.5 million impact from 2017 to 2025.

 

The U.S. Court of Appeals for the Seventh Circuit expanded the definition of "referral" under the Anti-Kickback Statute which puts some arrangements that were previously considered safe in danger. In U.S. v. Patel the court concluded an illegal referral occurs when a physician either directs a patient to a particular provider or allows patients to receive care from that provider.

 

A new bill titled the American Liberty Restoration act was introduced in Congress to overturn the Affordable Care Act's individual mandate. This is the first bill introduced by a Senate majority party to overturn the individual mandate.

 

A Michigan representative introduced a bill that would prohibit health and medical malpractice insurance issuers from engaging in anticompetitive activities.

 

The sign-up for HealthCare.gov was extended in 37 states until tax season after 800,000 health insurance enrollees received incorrect tax information.

 

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