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Medicare Test Would Make Hospitals Bear Risk for Hip and Knee Surgeries

Added 07.10.15

The CMS is planning to require hospitals in 75 geographic areas, including Los Angeles and New York City, to participate in a test of bundled payments for hip and knee replacements. more...

Obama’s CMS Nominee Slavitt Could Face Rough Road to Confirmation

Added 07.10.15

President Barack Obama has nominated Andrew Slavitt as CMS administrator, the position he has held on an interim basis since Marilyn Tavenner stepped down in February. more...

CMS Names 11 New Procedures for the ASC Payable List in 2016: Spine, Laparoscopy & More

Added 07.10.15

The Centers for Medicare and Medicaid Services proposed adding 11 new procedures to the ASC payable list next year, according to a report from ASCA. See all at: more...

New Bill May Alter Meaningful Use Among ASCs

Added 03.13.15

Ambulatory surgical centers (ASCs) — medical facilities that offer same-day surgeries as well as diagnostic and preventive care — do not have the same benefits as other healthcare institutions since there are no EHR products certified specifically for ASCs. Normally this would severely limit their ability to meet at least half of the meaningful use requirements and lead to a payment penalty. However, the House Ways and Means Committee voted in favor of the Electronic Health Fairness Act on February 27, which would exempt ASCs from the meaningful use program. The bill states that ASCs were not covered under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which developed certification standards strictly for hospitals and physician... more...

Bill That Aims to Reform North Carolina Surgeries Hits Lawmaker Floor

Added 03.13.15

A proposed law to bring major changes to surgery centers in North Carolina hit the legislative floor on Wednesday, 3/11/2015. Already, House Bill 200 was referred to three committees, a sign that lawmakers will take it seriously. In short, the new law would deregulate the process by which health care providers establish ambulatory surgery centers – those collections of operating rooms that perform outpatient procedures. Read the rest of this article from Triangle Business Journal at: more...

House Committee Passes Bill Exempting Ambulatory Surgical Centers from EHR Program

Added 03.11.15

On February 27, the House Ways and Means Committee passed the Electronic Health Fairness Act (HR 887), which would exempt ambulatory surgical centers (ASCs) from the EHR Incentive Program. ... Under the EHR Incentive Program, hospitals and eligible professionals that demonstrate the meaningful use of electronic health records qualify for Medicaid and Medicare incentive payments.  They may also be penalized for failing to meaningfully use EHR.  Eligible professionals must demonstrate that 50% or more of their outpatient encounters occur at locations equipped with EHR technology in order to be considered a meaningful user. The Electronic Health Fairness Act would exempt “any patient encounter . . . occurring at an ambulatory surgical center from being treated as such an encounter” when determining whether the professional qualifies for EHR... more...

Federal appeals court expands definition of ‘referral’ under Anti-Kickback Statute

Added 03.11.15

The U.S. Court of Appeals for the Seventh Circuit has expanded the definition of "referral" under the Anti-Kickback Statute, causing some provider arrangements that were once safe to now implicate the Anti-Kickback Statute, according to a National Law Review report. In the case of U.S. v. Patel, the court held a violation of the statute can occur when a healthcare provider authorizes a patient for specialist treatment even without referring a patient to a specific specialist, according to the report. Read the rest of this article from Becker's Hospital Review at: more...

The Affordable Care Act: Early Verdict Is Decidedly Mixed

Added 03.11.15

Patient deductibles and insurance company profits are too high, say readers. How is Obamacare affecting outpatient surgical facilities? Our poll of physicians and administrators strongly reflects the deep divide that characterizes the national debate about healthcare reform. Some say it's hurting business. Some say it's helping. Some say it goes way too far. Some say it doesn't go far enough. Almost half say they'd like to see the law repealed, but more than half wouldn't, or at least wouldn't unless there's a better way to reduce the vast number of uninsured Americans. Others say patience is the key. Read the rest of this article from Outpatient Surgery Magazine at: more...

Spine surgery for Medicare patients in ASCs in 2015 — But will spine make good business sense?

Added 02.20.15

The Centers for Medicare and Medicaid Services approved several new codes for spine surgery in ambulatory surgery centers, which is a big, controversial step. The new procedure codes on the ASC payable list for 2015 include the following: • Neck spine fusion • Lumbar spine fusion • Spine fusion extra segment • Neck spine disc surgery • Laminectomy single lumbar • Removal of spinal lamina (code 63045) • Removal of spinal lamina (code 63047) • Decompression spinal cord Read the rest of this article from Becker's ASC Review at: more...

ASC Payment Increase of 0% Proposed by MedPAC for 2016

Added 01.15.15

The Medicare Payment Advisory Commission (MedPAC) approved a recommendation that ASCs receive a 0% increase in payment rates for 2016. The commission once again approved a recommendation that ASCs be directed to report cost data. ASCA Chief Executive Officer Bill Prentice denounced the recommendation, stating, “MedPAC’s decision not to recommend any payment update for ASCs in 2016 is an insult to the thousands of ASCs that are saving the Medicare system billions of dollars by their very existence as an alternate site for outpatient surgical care. In addition to the 0% increase in ASC payments, the commission recommended a 3.25% increase in payment rates for inpatient and outpatient hospitals in 2016. “Once again, the commissioners suggest that Medicare penalize the most efficient care... more...