News | July 16, 2007

FASA Weighs in on Medicare ASC Payment Reform

July 17, 2007 – FASA, the national association representing ambulatory surgery centers (ASCs), commented on the CMS’ final rule to reform the way Medicare sets payments for surgical procedures performed in ASCs. Effective January 1, 2008, the CMS rule sets ASC payment rates at no more than 67 percent of the corresponding hospital outpatient department (HOPD) rates for the same procedures. If proposed HOPD rates are adopted, ASC payment rates would be no more than 65 percent of the corresponding HOPD rates.

“While we are pleased that CMS has increased ASC payment rates from its proposed rule,” said FASA President Kathy Bryant, “we don’t believe CMS has gone far enough. To ensure that patient choice and patient access to top-quality surgical care are protected, we believe these payments need to be much higher and other provisions of the new rule need to be changed.”

“In 2003,” continued Bryant, “ASCs were paid approximately 86.5 percent of HOPD rates. In addition, an industry analysis shows that maximum benefits, while complying with statutory restrictions, would be achieved if ASCs received approximately 75 percent of the HOPD rates. Because CMS is still setting ASC payment rates so low, payments for some procedures will be cut significantly. On top of four years without a payment increase, this is likely to mean that some procedures now performed in ASCs will be forced back into the hospitals, where those procedures will ultimately cost Medicare and its beneficiaries more.”

“By failing to directly link the ASC and HOPD payment systems,” Bryant asserted, “CMS lost a real opportunity to improve health care cost transparency for beneficiaries. The continued differences in the two payment systems this rule includes will make it impossible for beneficiaries to directly and easily compare the costs of having surgery in ASCs and HOPDs, and to make informed choices about their healthcare.”

FASA did express support for provisions in the rule that (1) expand the list of procedures Medicare will reimburse ASCs for providing, (2) allow Medicare payments for fluoroscopy services, (3) provide for full payments for implants and other devices for Medicare beneficiaries and (4) incorporate a phase-in period for the new payment system.

For more information: www.fasa.org

Related Content

Technology | June 12, 2008
The Nellcor Oximax pulse oximetry system reportedly allows clinicians to more effectively monitor a broad range of pa
News | May 27, 2008
May 28, 2008 - Somanetics Corp.
Technology | May 19, 2008
Mindray's PM-60 pulse oximeter is designed with a 2.4-inch color LCD display.
News | May 18, 2008
May 19, 2008 - Mindray featured its PM-7000 multiparameter patient monitor at ASCs 2008.
News | April 22, 2008
April 23, 2008 – According to a report released by Global Industry Analysts Inc., the pulse oximetry sector exhibits
News | April 03, 2008
April 4, 2008 – Masimo said yesterday the Japanese Ministry of Health, Labor and Welfare (MHLW) approval of its PVI m
News | March 19, 2008
March 20, 2008 - A new clinical study recently published in the Journal of Emergency Medicine found the Masimo Rainbo
News | February 13, 2008
February 14, 2008 – Masimo yesterday said the University of California at San Francisco Medical Center completed its
News | January 22, 2008
January 23, 2008 - Masimo said yesterday it signed a three-year supplier agreement with HealthTrust Purchasing Group,
Overlay Init