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

ASCA Comments on CMS’ Proposed Payment Rule

In early September, ASCA submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) on Medicare’s proposed 2018 ASC payment rule. Also known as the 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule, it recommends ASC reimbursement rates for the coming year and other payment policies, including Medicare quality reporting requirements.

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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 2018

Bringing Cardiac Cases into ASCs

Come to ASCA 2018 to learn how to run a successful heart-centered surgery center

Interest in performing cardiac procedures in the outpatient setting is growing, and the Heart and Rhythm Institute of Trinity is at the forefront of the movement. Although the Centers for Medicare and Medicaid Services (CMS) does not yet reimburse ASCs for these procedures, many managed care companies do. With an increasing number of outpatient centers providing cardiac procedures, growing awareness of the cost savings and the positive experiences that patients report, the chances of cardiac procedures being performed in ASCs is rising.

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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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OSHA Updates Its Regulations

Learn how to implement the revised reporting requirements

In 2013, the Occupational Safety and Health Administration (OSHA) issued a proposed rule to improve the tracking of workplace injuries and illnesses through the electronic collection of establishment-specific injury and illness data. After receiving comments on the proposal, OSHA issued the final rule that became effective January 1, 2017 (Occupational Safety and Health Administration 29 CFR Part 1904). For more information on the final rule, click here. Although ASCs are partially exempt from some of the requirements in that rule, they are subject to a requirement that prohibits employers from discouraging workers from reporting an injury or illness.

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Doing Business

Not Too Late to Succeed Under MIPS

Adopt next-generation technology to stay on top of your game

Almost a full year has passed since the Centers for Medicare & Medicaid Services (CMS) deemed 2017 as the transitional year for independent physicians to comply with the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA has two available tracks: Alternative Payment Models (APMs) and a Merit-Based Incentive Payment System (MIPS).

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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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Rein in Surgical Case Coordination Inefficiencies

Cloud-based technology can help ASCs overcome fragmented case communication issues

Designed to be efficient, ASCs provide a more focused and specialized approach to surgeries without the costly overhead typical in a hospital environment. The result is high-quality care with better patient satisfaction. When it comes to surgical case coordination, however, the natural evolution of technology and communication has created a fragmented mess involving email, text messages, phone calls, white boards and word of mouth.

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Take Your ASC Revenue Cycle to the Next Level

Your employees are the most important tool to success

We all know every penny counts, but the rapidly changing rules surrounding ASC reimbursement can make revenue cycle management difficult. We can be ready for whatever changes come our way if we have the right tools, anticipate and adapt. When we think “tools,” we generally think software, hardware and medical equipment, but the most important tool for an ASC’s success is something else that is sometimes forgotten. More on that later. Below are a few tips to manage your revenue cycle successfully.

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Regulatory Review

Make Compliance Easier

Put ASCA’s regulatory resources to work in your ASC

With Medicare’s 2018 payment rule in final form and the calendar refreshing toward a new year, now is a good time for ASCA members to consider how to make the most of all the regulatory resources ASCA makes available for their use each year.

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Advocacy Spotlight

2017 in the Rearview

ASCs and state associations join hands to defeat legislative challenges

In 2017, state lawmakers across the country filed more than 180,000 bills and enacted nearly 35,000 of those. Given that volume, it is not surprising that the ASC community found itself objecting to several legislative proposals during the 2017 legislative session.

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Register Now to Save on ASCA’s Winter Seminars

Get the new year off to a great start by attending one of ASCA’s 2018 Winter Seminars, January 11–13, in Las Vegas, Nevada.

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Web Crawl


Beginning November 15, subscribers to ASCA’s clinical and operational benchmarking program can access their third-quarter (Q3) reports by logging into the ASCA Benchmarking portal.

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