In March, the U.S. Department of Justice (DOJ) launched the Anticompetitive Regulations Task Force, an initiative meant to eliminate laws and regulations that “undermine free market competition.” Ambulatory surgery center (ASC) stakeholders are already playing an important role in the task force’s mission. “This Antitrust Division will stand against harmful barriers to competition whether imposed by public regulators or private monopolists,” Assistant Attorney General Abigail Slater of the … [Read more...]
CMS Innovation Strategy Teases Focus on Outpatient Care – And Potential Opportunities for ASCs
The U.S. Centers for Medicare & Medicaid Services (CMS) and its Innovation Center are doubling down on preventive care while striving to shift care away from the traditional acute care hospital. For ambulatory surgery centers (ASCs), that could mean – at least in theory – more opportunities to participate in innovative payment models in the not-too-distant future. On May 13, CMS and the Center for Medicare and Medicaid Innovation (CMMI) unveiled their “Making America Healthy Again” … [Read more...]
‘We’re Really Going to Get on the Ball Very Early in the Year’: ASC Leaders Eager to Engage Trump Administration on CMS Rulemaking
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...]
CMS Proposes New Medicare Advantage Policies, Seeks Coverage for Weight-Loss Drugs
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...]
[Updated] CMS Finalizes 2.9% Medicare Payment Update for ASCs in 2025
The Centers for Medicare & Medicaid Services (CMS) has finalized 2025 Medicare payment rates and quality reporting program updates for ambulatory surgery centers (ASCs). ASC payment rates will increase 2.9% in CY 2025 for centers meeting relevant quality reporting requirements, according to a final rule that CMS issued Friday. The rule received backlash from industry stakeholders. “This final rule is a step sideways in a time when millions of Medicare beneficiaries need CMS to advance … [Read more...]
ASC Providers Slam CMS Inaction on Cardiology Codes, Confusing COVID Vaccine Reporting
In its 2025 proposed payment rule for ambulatory surgery centers (ASCs), the U.S. Centers for Medicare & Medicaid Services (CMS) floated a 2.6% increase to surgery center payments and adjustments to select quality-reporting measures. One thing CMS didn’t call for: key additions to the ASC Covered Procedures list for 2025. “It is disheartening that CMS established a new, supposedly more transparent process for submitting procedure codes that could be added to the ASC Covered Procedures … [Read more...]
What ASCs Should Know About Information Sharing
The U.S. Department of Health and Human Services (HHS) released a final rule on June 24 that established disincentives for health care providers who practice information blocking. That could include ambulatory surgery centers (ASCs). Under the 21st Century Cures Act, the secretary of the HHS has exercised the department’s authority to establish "disincentives" for health care providers who knowingly engage in practices that unreasonably interfere with the access, exchange or use of … [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...]