1. CMS repealed same-day surgery provision. In October, the Centers for Medicare & Medicaid services reversed its long-standing limitation on surgery centers performing procedures on the day they are scheduled. ASCs will now be allowed to provide patient notifications on the day the procedure is performed, allowing same-day surgeries. The ASC Association lobbied for the elimination of this condition of coverage throughout 2011, believing that the move would improve patient choice, reduce costs and remove an unnecessary regulatory burden from surgery centers. The revision is expected to take effect on Dec. 23.
Responding to comments on the proposed revision, CMS officials said, “We agree that placing limitations on the types of surgeries an ASC can perform on the same day patients present at the ASC with physician referrals is unduly restrictive and that ASCs could be unreasonably disadvantaged compared to hospital outpatient departments … these restrictions could limit patient access to non-emergent procedures at ASCs and limit patient choices, create patient scheduling inconveniences and create patient travel issues.”
2. ASCs received higher-than-expected reimbursement update. On Nov. 1, CMS issued a final rule that established payment rates for calendar year 2012, increasing payment rates to ASCs by 1.6 percent in CY 2012. The increase reflects a consumer price index for all urban consumers estimated at 2.7 percent, minus a 1.1 percent productivity adjustment required under the federal healthcare reform law. While ASC advocates still believe ASC payment updates are based on a flawed measurement — CPI-U — compared to hospital outpatient departments, the payment rate was higher than the expected 0.9 percent originally proposed by CMS.
CMS projected that payments to approximately 5,000 Medicare-participating ASCs under the ASC payment system would be approximately $3.5 billion for CY 2012. In comparison, payments to more than 4,000 hospitals paid under the Outpatient Prospective Payment System in CY 2012 are expected to total around $41.1 billion.
3. CMS postponed the quality reporting program start date. CMS postponed the start date for the proposed Quality Reporting Program from Jan. 1, 2012 to Oct. 1, 2012. This change gives ASCs more time to prepare for the reporting requirements. Beginning on Oct. 1, surgery centers will be required to report data on the following five measures:
1. Patient burn.
2. Patient fall.
3. Wrong site, side, patient, procedure, implant
4. Hospital admission/transfer
5. Prophylactic IV antibiotic timing
2013 will usher in the addition of two more measures — safe surgery checklist use in 2012 and 2012 volume of certain procedures. While ASCs won’t have to report information on these two measures until 2013, they will be expected to report data based on activities conducted in 2012. This means that an ASC should ensure it is using a safe surgery checklist and can capture surgical volume data by Jan. 1, 2012.
4. Small business paperwork elimination act passed. In April, President Obama signed a repeal of the 1099 tax reporting requirement in the healthcare reform law. The unpopular provision, which the ASC Association lobbied to remove along with other groups, would have raised funding for healthcare reform by forcing businesses such as ASCs to file 1099 tax reporting forms for payments of $600 or more, making it easier for the IRS to identify taxes on those payments. Small businesses complained the reporting would have been onerous.
The bill, which was approved by the House and the Senate before receiving President Obama’s signature, offset an estimated $21.9 billion in lost income from the provision by requiring consumers to return more of their tax subsidies to purchase health insurnnace if their income changes during the year and they are eligible for less assistance. The 1099 provision would have added increased financial burden to small surgery centers, which often lack the staff resources to report these transactions.
Learn more about the ASC Association.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
