MASCA Sues State Over Surprise Regulations, Fees to Contract With Medicaid

The Missouri ASC Association has filed a lawsuit against the Missouri Department of Social Services and Missouri HealthNet Division, the state’s division of Medicaid, over regulations requiring ASCs to contract with and pay an annual fee to a patient safety organization (PSO) to then have the ability to enroll with MO HealthNet.

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Following a federal mandate requiring Medicaid providers to have a relationship with a federally-listed PSO, Missouri was the only state to apply the regulations not just to hospitals but also ASCs, according to Jill Watson, executive director of MASCA

ASCs are now required to contract with the PSO so they can enroll with Medicaid, which will cost each ASC $2,500 annually. Furthermore, Ms. Watson says the reporting used to comply with the PSO requirements use hospital forms and standards not used in the ASC industry, which places an unnecessary regulatory burden on the surgery centers.

Ms. Watson says MASCA is challenging the regulations based on the failure of state regulators to perform a required review of the impact on small businesses of a burdensome expense associated with a new regulation (prior to it becoming final), with burdensome defined as $500 or less; the expense in this case is the $2,500 expense for each small business (ASC).

“We’re hoping to engage the department in a dialogue about that and have the rule rescinded,” says Ms. Watson. “The state has imposed this needless regulation and the lawsuit is really the only avenue that is left to challenge it.”

View the MASCA lawsuit (pdf).

Learn more about MASCA.

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