ASC Association's William Prentice: 3 Provisions of the Ambulatory Surgical Center Quality and Access Act

In a presentation at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 10, William Prentice, JD, executive director, ASC Association, shared three key provisions contained in the Ambulatory Surgical Center Quality and Access Act — a piece of legislation that was recently introduced in both the House and Senate and discussed other key priorities for the ASC Association.

Mr. Prentice said the ASC industry has improved its lobbying efforts in the past year and while the ASC industry's influence will never reach that of the hospital industry's, ASCs can successfully lobby their interests. "We don't have to have as much as the hospital industry, we just have to have enough," he says. 

One of the top priorities of the ASC Association is winning approval for an ASC bill currently being considered by Congress. Reps. Pete Sessions (R-Texas) and John Larson (D-Conn.) are sponsoring the bill in the House. The bill was introduced just yesterday in the Senate, where it is being sponsored by Sens. Ron Wyden (D-OR) and Mike Crapo (R-ID).

The bill contains three major provisions benefiting ASCs.

1. Repeal of the urban consumer price index to determine Medicare rate updates. The legislation would replace the use of the consumer price index for all urban consumers with use of the hospital market basket in determining payment updates. While Mr. Prentice notes this won't lead to an immediate uptick in ASC reimbursements, it will "stall the delta between what hospitals and ASCs are reimbursed for the same services."

2. Quality reporting requirements. The bill will implement a quality reporting program for ASCs, which Mr. Prentice says will give surgery centers "a better way to prove our story of quality." This provision allows the industry to get out in front of and have a say in quality reporting, which could be required of ASCs by CMS as soon as summer. 

3. Value-based purchasing. The bill also includes a value-based purchasing program that would reward ASCs with high-quality outcomes. The provision would establish benchmarks for outpatient surgical quality and would set-up a "pot of money pulled from ASC and hospital outpatient reimbursements" that would be distributed to high-quality facilities, says Mr. Prentice. Poor performing facilities would not have reimbursements reduced under the provision. "[ASCs] might capture money that might otherwise go to hospitals," he said. 

Mr. Prentice also encouraged those within the ASC industry to take part in grassroots-level work to advance ASC interests, telling conference attendees, "Every legislator in the country needs to know what an ASC is, what type of care they provide and who you are….If a piece of legislation is in front of them that may impact an ASC, they should know to call you," he said.

He also discussed the ASC Association's efforts to establish a demonstration project within the Center of Medicare and Medicaid Innovation that would pilot moving a number of procedures currently not reimbursed by Medicare in the ASC setting into surgery centers. Mr. Prentice said the project would "allow us to prove we can do these procedures safely on Medicare patients as we've already been doing on the commercial ledger and produce, we think, tremendous savings for [CMS]." Mr. Prentice said he expects a meeting with the Center of Medicare and Medicaid Innovation in the next few weeks.

Previous Articles on Ambulatory Surgical Center Quality and Access Act:
Ambulatory Surgical Center Quality and Access Act Introduced in Senate

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