CMS

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...]

Improper payments in Medicare and Medicaid – overpayments, underpayments, or payments where insufficient information was provided to determine whether a payment was “proper” – remain on the downswing. Specifically, the estimated improper payment rate for fee-for-service Medicare in Fiscal Year 2025 was 6.55%, or $28.8 billion, according to the U.S. Centers for Medicare & Medicaid Services (CMS). That’s down from 7.66%, or $31.7 billion, for Fiscal Year 2024. Contextually, the Medicare … [Read more...]

The U.S. Centers for Medicare & Medicaid Services (CMS) this week took major steps to operationalize one of the largest federal investments in rural health care in decades, formally establishing a new agency office and announcing the distribution of $50 billion in funding to all 50 states aimed at strengthening care delivery in rural communities. On Dec. 29, CMS announced the creation of the Office of Rural Health Transformation (ORHT) within the agency’s Center for Medicaid and CHIP … [Read more...]

Not every story that shapes the ambulatory surgery center (ASC) industry does so with splashy headlines or massive traffic numbers. Some of the most consequential developments unfold more quietly: through pilot programs, early-stage platforms, regulatory experiments or strategic bets that signal where the market may be headed next. In 2025, ASC News published several such stories that didn’t dominate the click charts but offered insight into how outpatient care is evolving beneath the … [Read more...]

From seismic policy shifts to blockbuster deals and the accelerating migration of higher-acuity care into the outpatient setting, 2025 was a defining year for the ambulatory surgery center (ASC) industry. ASC News readers gravitated toward stories that captured an industry in transition – one balancing rapid growth and innovation with mounting regulatory action, reimbursement pressures, and questions about scale, ownership and independence. Clinical evolution was another important theme. … [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 U.S. Centers for Medicare & Medicaid Services (CMS) on Nov. 21 moved forward with its plans to substantially expand the list of procedures outpatient surgery centers are allowed to perform. The agency also solidified its proposal to phase out Medicare’s inpatient-only list. Broadly, ambulatory surgery center (ASC) leaders have supported CMS’ July 2025 proposal to shift more surgical procedures away from the traditional hospital setting. While such a shift has been happening over the … [Read more...]

Opening an ambulatory surgery center (ASC) in a rural area means significant challenges, including a shortage of skilled health care staff, geographic isolation and a smaller patient base, all of which can make it difficult to achieve high surgical volumes and maintain profitability.  Other obstacles include poor infrastructure, limited access to reliable transportation and supply chain issues that can increase operational costs. “There has not been much new development in rural health … [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 future looks promising for ambulatory surgery centers (ASCs) as the health care industry’s focus on cost efficiencies shifts toward where surgical procedures are performed.  Surgeries with increasing complexity, once limited to hospitals, are now shifting to ASCs, indicating continued growth for the foreseeable future. A recent Jefferies equity research report highlighted the structural tailwinds driving this transformation and projected 6% to 8% growth for the ASC sector through … [Read more...]