“The ASC Quality and Access Act is critical to the viability of ASCs and would ensure that Medicare would save more than $2.3 billion every year,” said ASCA CEO William Prentice.
The Congressmen introducing the bill were Devin Nunes (R-CA) and John Larson (D-CT).
Here are five things to know about the legislation:
1. The bill fixes the law allowing CMS to use different inflation measures for ASCs and hospital outpatient departments when setting payment rates.
2. The change would prevent procedures from migrating from the ASC where there is lower reimbursement to the HOPD where there is higher reimbursement and the procedures are more expensive.
3. The bill requires quality reporting transparency. CMS would be required to publish relevant quality data and make the data accessible to patients.
4. CMS would be directed to add an ASC community representative to the advisory panel on hospital outpatient payment.
5. CMS would be required to disclose which criteria trigger procedures being excluded from the ASC-approved list.
“While ASCs and hospital outpatient departments provide identical outpatient surgical care, ASCs are reimbursed by Medicare at a significantly lower rate than HOPDs and this payment disparity is on track to continue to increase,” said Mr. Prentice. “The current reimbursement structure is illogical and unsustainable.”
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