News | October 30, 2007

FASA Applauds Senator for Leadership in ASC Payment Reform

October 31, 2007 - FASA, the national association representing ambulatory surgery centers (ASC), is commending Senator Mike Crapo (R-ID) for his leadership in impacting change to expand Medicare beneficiary access to critical surgical services.

On Oct. 26, 2007, Senator Crapo introduced the Ambulatory Surgical Center Medicare Payment Modernization Act of 2007 (S. 2250) into the US Senate. If enacted, this legislation would reportedly improve the ASC payment system and the mechanism that the Centers for Medicare and Medicaid Services (CMS) uses to determine what procedures Medicare reimburses ASCs for providing.

Similar to H.R. 1823, which was introduced in the US House of Representatives earlier this year by Representatives Kendrick Meek (D-FL) and Wally Herger (R-CA), this legislation links ASC payments to the payment system of hospital outpatient departments (HOPDs) in an ongoing manner and would require the Centers for Medicare and Medicaid Services (CMS) to pay ASCs 75 percent of the HOPD rate.

This is in contrast to the Medicare ASC payment reform CMS finalized earlier this year that results in payments to ASCs of 65 percent of the HOPD rate and, due to different annual updates for ASCs and HOPDs, will result in rates in both settings that will continue to diverge over time.

Provisions in the new bill are patterned after the Medicare Payment Advisory Commission’s recommendation that ASCs should be authorized to perform and receive Medicare facility payments for any surgical service, except for those procedures where the Department of Health and Human Services secretary identifies a specific risk concerning a certain procedure being performed in an ambulatory surgical setting or an overnight stay is required. In contrast to the final Medicare reforms, the legislation does not use a number of arbitrary criteria to determine what procedures are excluded.

For more information: www.fasa.org

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