Chronic pain procedures are increasingly being performed in ambulatory surgery centers (ASCs), offering patients quicker access, lower costs and reduced infection risks compared to traditional hospital settings, especially benefiting older adults on Medicare. However, challenges remain in maintaining effective pain management and navigating regulatory and reimbursement hurdles. “Reimbursement is always a challenge,” Jennifer Hodge, COO of Palmetto Pain Management, told ASC News. “Some … [Read more...]
‘The Current Policy Is Unfair’: Medicare Copay Fairness Act Gains Additional Support
The Medicare Beneficiary Copay Fairness Act is gaining momentum. Rep. Marc Veasey (D-Texas) has joined as one of the newest cosponsors of the Act. The bipartisan bill was introduced on April 24 and addresses a Medicare payment rule for ambulatory surgery centers (ASCs), where Medicare Part B beneficiaries pay a standard 20% coinsurance for procedures at both ASCs and hospital outpatient departments (HOPDs). However, only HOPD copays are limited by the inpatient deductible, which is … [Read more...]
ASCs Insulated from Medicaid Cuts, But Operators Must Prepare for Fast-Changing Health Care Regulatory Landscape
House Republicans on Sunday introduced a bill that includes significant cuts to Medicaid funding, including tighter eligibility requirements and reduced reimbursements to states. Some estimates show that the GOP-proposed changes would equate to about $715 billion in Medicaid cuts down the road. This comes amid a broader push to offset tax cuts introduced during the Trump administration. While the proposed cuts could deeply affect hospitals and other health care providers with a … [Read more...]
Oz Confirmed as CMS Chief: What ASCs Should Know
The Senate confirmed Dr. Mehmet Oz as the new administrator of the Centers for Medicare & Medicaid Services (CMS), doing so by a 53-45 margin. Most senators voted along party lines. Oz’s confirmation will likely portend policy and regulatory shifts that may impact ambulatory surgery centers (ASCs). Oz’s public statements during his confirmation hearings focused heavily on post-acute care and skilled nursing concerns, but he also hinted at broader reimbursement and regulatory … [Read more...]
How Accreditation Sharpens ASCs’ Competitive Edge
Accreditation is often viewed as a regulatory necessity, but for ambulatory surgery center (ASC) operators, it can also serve as a powerful marketing tool.. “It’s kind of like the Good Housekeeping Seal of Approval,” according to Laurie Roderiques, RN, director of clinical services for Ambulatory Healthcare Strategies. “That can possibly put you a leg up on someone else.” Roderiques spoke at the recent virtual conference hosted by John Goehle. The primary accrediting organizations for … [Read more...]
ASCA Urges CMS for Updated Payment Rates, Calls for Covered Procedures List Expansion
The Ambulatory Surgery Center Association (ASCA) recently submitted comments calling for significant changes to the Centers for Medicare & Medicaid Services (CMS) proposed 2025 payment rule for ASCs and hospital outpatient departments (HOPDs). In a letter to CMS, ASCA said that CMS should consider updating payment rates, expanding the ASC Covered Procedures List (CPL) and changing new quality reporting measures. Under the proposed rule, ASCs would receive an effective update of 2.6%, … [Read more...]
New Survey Offers Inside Look at ASC Quality-Reporting Program, Challenges for Operators
The vast majority of ambulatory surgery center (ASC) operators participate in the Ambulatory Surgery Center Quality Reporting (ASCQR) Program, a new industry survey suggests. The ASCQR Program requires ASCs to report specific quality measures to the U.S. Centers for Medicare & Medicaid Services (CMS). The Ambulatory Surgery Center Association (ASCA) looked at participation in a recent survey, publishing results on Aug. 30. The survey collected 321 responses from surgery centers across … [Read more...]
CMS to End Advanced Payment Program Tied to Change Healthcare Cyberattack: What ASCs Should Know
Ambulatory surgery centers (ASCs) and other health care providers experienced pronounced payment disruptions earlier in 2024 due to the Change Healthcare cyberattack. Many of these health care providers mitigated the financial impact of that disruption via a form of short-term loan from the government. This lifeline will soon go away, however. The Centers for Medicare & Medicaid Services (CMS) recently announced that its advanced and accelerated payment program tied to the cyberattack … [Read more...]