Message from the President

Look to ASCA, Talk to ASCA to Get the Services You Need

ASCA rolled out a new program this year that gives the association’s facility members and ASCs across the country easy access to several important resources they can use to meet regulatory requirements, cut costs, educate staff and continue to deliver top-quality patient care.

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Message from the CEO

2018 Proposed Rule Shows Results of ASCA’s Hard Work

The Centers for Medicare & Medicaid Services (CMS) released its 2018 proposed payment rule for ASCs and hospital outpatient departments (HOPDs) in July. While the proposal did not address all of ASCA’s concerns regarding Medicare reimbursement for ASC services, it did show a greater recognition of the evolution in care being provided in ASCs.

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As I See It

Ins and Outs of H&P

Make sure you know the how, what and when behind these critical assessments

The minimum requirement for a preop history and physical (H&P) is well defined in the Centers for Medicare & Medicaid Services’ (CMS) Conditions for Coverage (CfC).

  1. According to §416.52 Conditions for Coverage Q-0261 (Rev. 71, Issued: 05-13-11, Effective: 5-13-11-Implementation: 05-13- 11) §416.52(a) Standard: Admission and Pre-surgical Assessment: Not more than 30 days before the date of the scheduled surgery, each patient must have a comprehensive medical history and physical assessment completed by a physician (as defined in section 1861(r) of the Act) or other qualified practitioner in accordance with applicable State health and safety laws, standards of practice, and ASC policy. (Please check your state and accrediting body requirements to ensure you will not be held to a more stringent timeframe).

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ASCA 2017

Considering a Social Media Policy?

Come to ASCA 2017 to learn how

Does your ASC have a social media policy? Or does your center want a social media policy but not know where to begin? If you answered “yes” to either of those questions, you need to attend my presentation, “Social Media Issues from an HR Perspective,” at ASCA 2017, May 3–6, in Washington, DC.

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Coding Audits

Keep your ASC safe from hacking

What are the sounds of silence? Announce a coding audit during your next staff meeting and you will quickly find out.

This feared exercise need not inspire dread. In fact, while a coding audit might seem stressful, it is a straightforward, valuable learning opportunity that can position a facility for long-term success in today’s fast-changing, hypercompetitive health care market. Through regular coding audits, ASCs can improve compliance, eliminate inefficiencies and optimize revenue and financial performance.

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Make HIPAA Compliance a Top Priority

Avoid these missteps in your ASC

Despite extensive media coverage regarding the Department of Health and Human Services Office of Civil Rights (OCR) Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliance audits and penalties, HIPAA compliance programs still are not given top billing in some ASCs.

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Doing Business

Attain Compliant Revenue Cycle Management

Focus on providers’ reports, coding, billing and patient confidentiality

Obtaining the full reimbursement you deserve while remaining compliant with federal, state and managed care regulations is imperative to keeping your doors open and achieving year-over-year growth. Several areas in your revenue cycle that affect compensation also are potential areas for noncompliance.

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Trends in Medical Risk Transfer

Risks that are uninsurable or prohibitively expensive to insure might call for alternative risk transfer

In an ever-changing world, it is no secret that risks associated with ASCs also are evolving. Trends in medical risk transfer, however, are generally not related to ordinary risks but rather nontraditional—low frequency/high severity—risks. If these risks occur, they have the ability to bring a practice to a screeching halt. Examples of such risks include: loss or suspension of professional license, legislative and regulatory changes, cyber risk (breach of customer data and detrimental code) and related Health Insurance Portability and Accountability Act of 1996 (HIPAA) violations.

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ASCA Advocates for Fair Implementation of Section 603

Congress passes site-neutral payment legislation

On November 2, 2015, congressional leaders and the Obama administration announced a bipartisan budget agreement that would fund the federal government for two years, raise the nation’s debt ceiling and stave off Medicare premium increases for beneficiaries. The final legislation, called the Bipartisan Budget Act of 2015, responded to a number approaching fiscal deadlines and leadership changes in the House that could have impacted the ability to strike such a deal.

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Smart Medicine

Bundled payment and stable orthopedic technology

Orthopedic implants in the US represent a multibillion- dollar industry. I estimate 75 percent of the orthopedic implant industry consists of devices that are “stable technologies,” which means they are time-tested devices with little changes in design and manufacture for many years.

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Regulatory Review

Joint Replacement Front and Center in OPPS/ASC Proposed Rule

CMS seeks feedback on the potential for adding TKA, PHA and THA to the ASC-payable list

Advances in medical technology have expanded the types of patients who can be treated outside the hospital. Despite these advances, the Centers for Medicare & Medicaid Services’ (CMS) payment policies have traditionally lagged innovation, and many procedures, such as total joints, are currently on the inpatient-only (IPO) list. Promising, though, is CMS’ recent proposal to remove total knee arthroplasty (TKA), code 27447, from the IPO list for 2018.

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Advocacy Spotlight

Trail Blazing

Vermont gets its first multi-specialty ASC

In July, state regulators of Vermont approved a certificate of need (CON) for the first multi-specialty and second independent ASC in the state. Amy Cooper, executive director of HealthFirst in Burlington, Vermont, talked to ASC Focus about her experience with the process that took three years to come to fruition.

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Attend ASCA’s October Webinars

ASCA will offer two webinars this month: “Protect Your Patients with a Comprehensive Surgical Instrument Safety Program” on Tuesday, October 10, and “Preparing for Electronic Health Records: What You Need to Consider When Preparing to Make the Change from Paper to an Electronic Workflow” on Tuesday, October 24. Both programs will be held at 1:00 pm ET.

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Web Crawl


The data collection period for the third quarter (Q3) of ASCA Benchmarking 2017 opens Saturday, October 1, and closes Tuesday, October 31. If you have not yet signed up for ASCA’s clinical and operational benchmarking program this year, subscribe now to access two quarters of your ASC’s benchmarking data plus a full year of data from other ASCs.

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