Regulation & Legislation

Ambulatory surgery center (ASC) stakeholders are raising concerns after the U.S. Department of Health and Human Services (HHS) announced its intention to rescind the long-standing policy requiring public participation in certain rulemaking processes, particularly those involving Medicare, Medicaid and reimbursement. The move could significantly limit opportunities for ASC operators and others to comment on future regulatory changes. And it might lead to legal challenges, too. “I believe … [Read more...]

Ambulatory surgery centers (ASCs) in Indiana could face a major reimbursement shift if new state legislation mandating site-neutral payments passes. In a recent Ambulatory Surgery Center Association (ASCA) audio update, Charlie Leonard, a member of ASCA’s public affairs team, spoke with ASCA Director of Government Affairs Stephen Abresch about Indiana House Bill (HB) 1003. The bill proposes to reimburse certain surgical procedures at physician office rates, regardless of whether they are … [Read more...]

The Ambulatory Surgery Center Association (ASCA) is calling on federal regulators to help support surgery centers across the U.S. In a Feb. 19 letter to the U.S. Centers for Medicare & Medicaid Services (CMS), ASCA laid out a series of recommendations aimed at bolstering ambulatory surgery center (ASC) payments while also expanding the number of procedures eligible for ASC reimbursement. The industry group also asked CMS to consider recalibrating quality reporting measures.  These … [Read more...]

Legislation to block cuts to Medicare payments for physicians is back on the table. On Jan. 31, U.S. Rep. Greg Murphy, who has a background as a medical doctor, reintroduced the bipartisan “Medicare Patient Access and Practice Stabilization Act.” A 2024 version of the bill was previously introduced in October. "Physicians in America are facing unprecedented financial viability challenges due to continued Medicare cuts,” Murphy, a Republican from North Carolina, said in a statement. “Access … [Read more...]

The number of ambulatory surgery centers (ASCs) operating in the fee-for-service Medicare landscape is rising. So, too, is the share of traditional Medicare beneficiaries served by ASCs. That’s according to the Medicare Payment Advisory Commission (MedPAC), which presented on the ASC market as part of its regular health care status report on Jan. 16. The objective of these regular MedPAC presentations is to educate commissioners on the various corners of health care, giving MedPAC the … [Read more...]

One of the most significant, sector-shaping trends in health care is the migration of care out of the traditional hospital and into lower-cost outpatient settings. Ambulatory surgery center (ASC) market growth reflects this idea. In light of this overarching theme of care shifting into non-traditional settings, the ASC industry has entered into a period of rapid change and fast-paced growth that’s certain to extend into 2025. More private equity investors will turn their attention to … [Read more...]

Last year was a pivotal year for the ambulatory surgery center (ASC) industry, marked by transformative trends, groundbreaking innovations and high-stakes decisions that reshaped the landscape. It was also an exciting year for us at Ambulatory Surgery Center News, as we launched in the summer of 2024 with a mission to deliver in-depth reporting and actionable insights tailored to ASC operators, investors, payers, clinicians and other stakeholders. Since our debut, we've brought you stories … [Read more...]

The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare policy, recommended a 1% base rate increase above current law to both hospital inpatient services and outpatient services for 2026.  With that increase, the overall increase would be 4.6% based on the current projected hospital market basket increase of 3.6% for 2026. Analysts at Macquarie Capital noted that a hospital rate increase would have a positive impact on ambulatory surgery centers, including … [Read more...]

After a somewhat disappointing rulemaking cycle for ambulatory surgery centers (ASCs) this year, 2025’s discussions with federal regulators will become all the more important. And a return to a Trump administration means ASC stakeholders will need to start those conversations sooner rather than later. “We're really going to get on the ball very early in the year in 2025,” Kara Newbury, chief advocacy officer for Ambulatory Surgery Center Association (ASCA), said during a recent podcast … [Read more...]

GLP-1s and Medicare Advantage (MA) are two potential headwinds for ambulatory surgery centers (ASCs), with each undoubtedly playing a larger role in 2025. Partly because of this increasingly prominent standing, the U.S. Centers for Medicare & Medicaid Service (CMS) proposed new policies related to both GLP-1s, or glucagon-like peptide-1s, and MA on Nov. 26. “This proposed rule includes more policies to remove unnecessary barriers to care stemming from the use of inappropriate prior … [Read more...]