ASCA

One of the largest health insurers in the nation is pushing a new out-of-network policy that could prove seriously challenging for ambulatory surgery centers (ASCs). Starting Jan. 1, 2026, Anthem will penalize hospitals, surgery centers and other facilities whenever those facilities use out-of-network providers for patients covered under Anthem commercial plans. In other words, the insurer is putting financial pressure on facilities to use only in-network resources, except in certain … [Read more...]

The U.S. Centers for Medicare & Medicaid Services (CMS) is delaying the implementation of its five-year prior-authorization demonstration for ambulatory surgery centers (ASCs). Originally, the prior-auth demo was set to go live in December 2025 across all participating states: California, Florida, Texas, Arizona, Ohio, Tennessee, Pennsylvania, Maryland, Georgia and New York. Now, the demo will be rolled out in two phases. ASCs in California, Florida, Tennessee, Pennsylvania, Maryland, … [Read more...]

The Centers for Medicare & Medicaid Services (CMS) has released the 2026 Medicare Physician Fee Schedule (PFS) final rule, which, as always, has a few key takeaways for ambulatory surgery centers (ASCs). The agency says the rule is focused on modernizing payment accuracy by finalizing an “efficiency adjustment” for select services and a one-time 2.5% increase in physician payments. “CMS is working to strengthen and transform Medicare for current and future generations while cracking … [Read more...]

The federal government officially shut down on Oct. 1 after Congress failed to reach agreement on a short-term spending bill. The immediate fallout will mean furloughs for hundreds of thousands of federal workers and stalled services across multiple agencies. For ambulatory surgery centers (ASCs), the impact may not be as direct as it is for hospitals or other federally funded programs, but industry leaders say ripple effects could be on the horizon if Congress does not act soon. “If … [Read more...]

The U.S. Centers for Medicare & Medicaid Services (CMS) floated big changes to the outpatient surgery landscape when the agency shared its 2026 proposed payment rule for ambulatory surgery centers (ASCs) on July 15. To recap, CMS’ proposal included doing away with the Medicare Inpatient Only List (IPO), adding to the ASC Covered Procedures List (ASC-CPL) and giving ASCs a relatively modest payment adjustment. CMS likewise proposed changes to the Ambulatory Surgical Center Quality … [Read more...]

Electronic health record (EHR) usage among ambulatory surgery centers (ASCs) continues to climb. That’s according to the Ambulatory Surgery Center Association’s (ASCA) July 2025 60-Second Survey. The survey found that 76% of ASCs now use an EHR. That’s the highest percentage since ASCA began asking the question in 2021, reflecting the increasing importance of EHR technology. “It's probably a few industry [and] health care trends happening simultaneously,” ASCA regulatory counsel Alex … [Read more...]

The U.S. Centers for Medicare & Medicaid Services (CMS) is calling for big changes to how – and where – surgical procedures are performed. Specifically, federal regulators are pushing to eliminate the Medicare Inpatient Only List (IPO) while significantly expanding the ASC Covered Procedures List (ASC-CPL). The agency floated those plans on July 15 when it released its 2026 ASC payment system proposed rule. While there’s much to unpack in the more than 900-page proposed rule, such … [Read more...]