A favorable advisory opinion from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) gives ambulatory surgery centers (ASCs) a look at how the watchdog views succession planning, family ownership transfers and physician investment under the federal Anti-Kickback Statute. In Advisory Opinion 26-04, OIG said it would not impose administrative sanctions on a California Medicare-certified ASC tied to a three-phase ownership transfer plan built around the … [Read more...]
‘I Have Seen It Too Many Times’: NOPAIN Act Targets Longstanding Pain Care Dilemma for ASCs
For years, ambulatory surgery center (ASC) operators have faced a basic reimbursement dilemma in post-surgical pain care. Opioids are cheap and easy to use, while some non-opioid alternatives are harder to justify from a payment perspective. The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act is meant to address that conundrum. The law, enacted in late 2022 and effective Jan. 1, 2025, temporarily allows separate Medicare payment for qualifying non-opioid drugs, biologics and … [Read more...]
DOJ Suit Against NewYork-Presbyterian Has Implications for ASC Steering
The U.S. Department of Justice (DOJ) sued NewYork-Presbyterian Hospital on Thursday, alleging the health system used insurer contract terms to block lower-cost health plan designs that could steer patients to competing providers, including ambulatory surgery centers (ASCs). The civil antitrust complaint, filed in the U.S. District Court for the Southern District of New York, claims that NewYork-Presbyterian violated Section 1 of the Sherman Act by restricting insurers from offering what the … [Read more...]
Higher H-1B Visa Costs Could Deepen Surgeon Shortages
Higher H-1B visa costs could worsen surgeon shortages in the communities that already have the fewest options for care, a new JAMA Surgery research letter suggests. The piece serves as a warning with implications for ambulatory surgery centers (ASCs) as they compete for physicians and expand access to outpatient services. Researchers found that 662 surgeons were sponsored for H-1B visas in fiscal 2024, accounting for 0.37% of the nation’s 176,616 surgeons. While a small share of the … [Read more...]
Surgeon-Policy Expert Dr. Thomas Tsai on Why Medicare’s IPO List Phaseout Could Backfire
The government is getting out of the way of surgery site-of-service decisions, but some experts fear insurers could be stepping in. In a recent article, ASC News examined the potential impact of the U.S. Centers for Medicare & Medicaid Services’ (CMS) plan to phase out the Medicare inpatient-only (IPO) list. Although the move has been applauded for reducing regulatory barriers for outpatient surgery, it has also raised concerns about payer pressure, administrative burden and patient … [Read more...]
State Officials Consider Shifting Some PCIs to Ambulatory Surgery Centers
New York regulators are poised to consider a narrow but potentially consequential shift in where certain cardiac procedures can be performed. At its Feb. 19 meeting, the New York State Public Health and Health Planning Council (PHHPC) may weigh a policy change that would allow some ambulatory surgery centers (ASCs) affiliated with general hospitals to perform percutaneous coronary interventions (PCIs), a minimally invasive procedure used to open blocked heart arteries. If approved, the state … [Read more...]
Cardiovascular Procedures Opening Up to ASCs, But Expansion Faces Steep Hurdles
More cardiovascular (CV) procedures are coming to ambulatory surgery centers (ASCs), but the barrier to entry remains high. Varied state regulations, high capital costs and tight staffing are likely to limit the pace of outpatient migration for these CV procedures, industry insiders told ASC News. “I don't think we're going to see a huge shift in volume in the first couple of years,” Kara Newbury, chief advocacy officer at the Ambulatory Surgery Center Association (ASCA), told ASC … [Read more...]
Top Ambulatory Surgery Center Trends for 2026
The ambulatory surgery center (ASC) industry enters 2026 with undeniable momentum – and a growing sense that the “easy” part of the outpatient shift is over. More procedures are moving out of hospitals, yes. And it’s true that payers, employers and patients all continue to favor lower-cost (and more convenient) sites of care. What’s more, regulators are expanding what ASCs can do, and investors still view the sector as one of health care’s few durable growth stories. But the operating … [Read more...]
CMS Explores ‘Made in America’ Supply Chain Incentives
The U.S. Centers for Medicare & Medicaid Services (CMS) is taking another stab at preventing the kind of supply chain shocks that left caretakers scrambling for masks, gloves and other essentials during the pandemic. In an advance notice of proposed rulemaking (ANPRM), the agency is seeking comment on new policy options aimed at strengthening domestic supply chains for personal protective equipment and essential medicines. Specifically, CMS is floating compensation for higher costs, … [Read more...]
Medicare’s IPO List Phaseout Raises Alarms on Patient Safety, Payer Pressures
The U.S. Centers for Medicare & Medicaid Services’ (CMS) plan to eliminate the Medicare Inpatient-Only (IPO) list could trade a blunt but important safeguard for a series of new challenges for surgeons. In particular, those challenges could include more payer pressure, more administrative disputes and heightened risks for patients, some surgical experts believe. Ambulatory surgery centers (ASCs) have largely praised the phasing out of the IPO list, seeing CMS’ plan as a means to … [Read more...]