Digital Debut

Digital Debut

Recognizing Urology and Prostate Cancer Awareness Month

September is Urology Awareness Month and Prostate Cancer Awareness Month. Based on ASCA’s analysis of Medicare data, around 1,000 Medicare-certified ASCs across 47 states treat patients with urological issues. In 2022, ASCs performed 235,000 urological procedures on Medicare fee-for-service (FFS) beneficiaries alone.


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ASCA President Mark Wainner Takes Part in White House Health Forum

Earlier this week, ASCA participated in the White House Healthcare Safety Forum hosted by the White House Office of Science and Technology Policy to recognize World Patient Safety Day on September 17.


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ASCA Advocates for Changes to CMS 2025 Proposed Payment Rule

Earlier this week, ASCA submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) 2025 proposed payment rule for ASCs and hospital outpatient departments (HOPD).


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ASCA Survey Provides Insight into Reporting ASCQR Measures

ASCA’s August 2024 60-Second Survey asked questions regarding the time and resources necessary to report measures in the Medicare ASC Quality Reporting (ASCQR) Program. The survey received 321 responses from surgery centers in 46 states.


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Comment Now on Medicare’s 2025 Proposed Rule

Submit your comments on the Centers for Medicare & Medicaid Services’ (CMS) 2025 proposed payment rule by September 9. ASCA will once again submit comments raising industry-wide concerns, but it is important that CMS hears from individual centers as well.


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HIPAA Biannual Update

During the first half of 2024, healthcare organizations across the country posted 359 breaches of protected health information (PHI) affecting 500 or more individuals. Consistent with previous updates, rises in unauthorized access or hacking comprised most—95 percent—of the breaches.


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ASCs Must Meet Updated Nondiscrimination Requirements

The recently released Section 1557 final rule (FR) from the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) creates three major deadlines for ASCs: July 5, 2024 (the rule’s effective date), November 2, 2024, and July 5, 2025.


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South Carolina Finalizes New ASC Licensing Regulations

Surgery centers in South Carolina now face new obligations due to implementation of the certificate of need (CON) reform that occurred on May 16, 2023. Based on that CON reform, the South Carolina Department of Health and Environmental Control finalized significant changes to the state’s ASC licensing regulations on June 28.


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CMS Releases 2025 Proposed Medicare Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2025 proposed payment rule for ASCs and hospital outpatient departments (HOPD) on July 10. Of note, CMS concurred with ASCA’s request and proposed to continue to align the ASC update factor with the one used to update HOPD payments through 2025.


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Sg2 2024 Annual Report Projects High Growth in ASC Volume

Between 2024 and 2034, ASC volume will go up 21 percent to 44 million, according to Sg2’s 2024 Impact of Change report. “The aging population, epidemiological drivers and improved diagnostic capabilities will drive increased demand for surgical services over the coming decade,” says Tori Richie, senior consulting director of intelligence at Sg2 and Impact of Change lead.


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Lawmaker Champions ASCs in Congress

Representative Beth Van Duyne (R-TX) is one of the most vocal supporters of the ASC community in the US House of Representatives. In 2023, she became a cosponsor of the Outpatient Surgery Quality and Access Act of 2023 (H.R. 972/S. 312).


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National Health Expenditures Projected to Exceed $5 Trillion in 2024

The Centers for Medicare & Medicaid Services' (CMS) Office of the Actuary recently released annually updated projections of National Health Expenditures (NHE) for the years 2023–2032.


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Facility Fee Restrictions Remain on the Agenda in 2024

Throughout 2024, state legislatures have kept the topic of facility fee restrictions alive, entertaining proposals that, if enacted, would prevent ASCs from billing facility fees.


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CMS Releases Top Citations from 2023

The Centers for Medicare & Medicaid Services’ (CMS) Quality, Certification & Oversight Reports (QCOR) page allows the public to pull citation frequency reports for both health surveys and Life Safety Code surveys. The 2023 survey data includes citations given during 3,023 ASC surveys.


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Louisiana Workers’ Compensation Reimbursement Overhaul Dies in Senate Committee

ASCA, in partnership with the Louisiana Ambulatory Surgery Center Association (LASCA), opposed Louisiana HB 863, which proposed a new workers’ compensation reimbursement schedule in the state.


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Three More States Adopt Surgical Smoke Evacuation Laws

Three more states—Minnesota, Virginia and West Virginia—have adopted surgical smoke evacuation requirements for ASCs and hospitals in the 2024 legislative session.


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National Advocacy Day Secures More Support for ASC Legislation

Since ASCA hosted its annual National Advocacy Day earlier this year, five new cosponsors have joined the Outpatient Surgery Quality and Access Act of 2023 (H.R. 972/S. 312).


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ASCA Opposes FTC’s Ban on Noncompete Agreements

The Federal Trade Commission (FTC) voted 3–2 to adopt the “Non-Compete Clause Rule,” or the final rule, last week. The final rule states that the use of noncompete agreements is an unfair method of competition and is thus comprehensively banned effective 120 days after the final rule’s publication in the Federal Register.


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ASCA Opposes Proposed ASC Prior Authorization Demonstration

ASCA submitted comments in response to the Centers for Medicare & Medicaid Services’ (CMS) proposed prior authorization demonstration project for ASCs, last week. ASCA also spearheaded a state association sign-on letter that included 27 state associations, and a specialty organization sign-on letter that included 16 organizations.


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ASCA 2024 Rocking Orlando

After three days of roaring success, the ASCA 2024 Conference & Expo will wrap up tomorrow. The Gaylord Palms Resort & Convention Center is humming with nearly 2,100 participants, 167 exhibiting companies and 45 unique sponsors.


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Shining a Light on National Minority Health Month

April is National Minority Health Month, a dedicated time to raise awareness about the health disparities faced by racial and ethnic minorities, as well as American Indian/Alaska Native (AI/AN) communities in the US.


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ASCA Continues to Advocate for Full Coverage of Colonoscopies

As Colorectal Cancer Awareness Month comes to an end, colorectal cancer (CRC) remains a serious threat, ranking as the second deadliest cancer in the US after lung cancer.


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Start on OAS CAHPS Survey Implementation Now

The Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey will become a mandatory component of the Centers for Medicare & Medicaid Services’ (CMS) ASC Quality Reporting (ASCQR) Program on January 1, 2025.


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National Advocacy Day Attendee Helps Secure New Congressional Supporter

Jennifer Hodge, chief operating officer at Carolina Interventional Pain Institute in Columbia, South Carolina, recently traveled to Washington, DC, to participate in National Advocacy Day and met with Representative Joe Wilson (R-SC).


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ASCA Members Make National Advocacy Day a Success

From February 26–28, ASCA members traveled from 28 states to Washington, DC, to participate in this year’s National Advocacy Day. In total, 76 ASCA members met with 161 members of Congress and their staff to educate them on ASCs and to urge them to support the Outpatient Surgery Quality and Access Act of 2023.


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Prepare for Third-Party Cybersecurity Incidents

Last week, a cyberattack on UnitedHealth Group paralyzed subsidiary Change Healthcare, part of Optum. This caused billing disruptions at different healthcare entities including at ASCs.


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Choose to Get Your ASC Accredited

Accreditation plays a vital role in validating the ASC community’s solid reputation of performing high-quality, safe care for the communities served. The standards, guidelines and best practices encompassed in the accreditation manuals guide ASC leaders through the myriad of healthcare regulations.


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Maine Legislature Balks at Site-of-Service Facility Fee Restrictions

During a February 6, 2024, hearing of the Maine State Legislature's Joint Standing Committee on Health Coverage, Insurance and Financial Services, the committee voted 7–5 to report out legislation related to transparency recommendations and restrictions on facility fees associated with telehealth services.


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HIPAA Biannual Update

During the last half of 2023, healthcare organizations across the country posted 336 breaches of protected health information (PHI) affecting 500 or more individuals. Consistent with previous updates, rises in unauthorized access or hacking comprised almost all—98 percent—of the breaches.


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State Legislatures Kick Off 2024 with Continued Focus on Healthcare

This year’s state legislative sessions are well underway, with 39 state legislatures actively meeting as of January 17, and the most unfortunate trend in healthcare policy in 2023, facility fee restrictions, already rearing its ugly head.


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Medicare Introduces New ASC Procedure Request Process

The Centers for Medicare & Medicaid Services recently rolled out the ASC Covered Procedures List Pre-Proposed Rule Recommendation Request, a new way to submit codes for consideration. With a March 1, 2024, submission deadline, now is the time to advocate for procedures to be added in 2025.


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Headwinds and Tailwinds Shaping ASC Performance

Asked to consider the challenges and opportunities ASCs will confront in 2024, Colin Park, managing director for VMG Health in Dallas, Texas, says, “The biggest difficulties concern expenses.” He puts staffing costs at the forefront.


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ASCA Advocacy Drives Success in 2023

2023 was a busy year for healthcare policies and ASCs were no exception. While ASCA has its work cut out for it in 2024, let’s take a minute to celebrate our successes from the past year.


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House Passes Healthcare Transparency Bill

On December 11, the US House of Representatives overwhelmingly passed the Lower Costs, More Transparency Act (H.R. 5378) by a vote of 320–71. If enacted, effective January 1, 2026, the bill will require ASCs to disclose to the public all standard charges and prices, including information relevant to ASCs on the list of 300 shoppable services or an indication that such service is not furnished by the ASC.


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State Legislative Trends in 2023

In 2023, ASCA tracked more than 650 bills across the 50 states for potential impacts on ASCs. Certain trends from past years continued, like the focus on surgical smoke evacuation requirements and state-level price transparency requirements. New, disturbing trends also arose, including facility fee prohibition proposals across the country.


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ASCA Survey Shows Salaries and Caseloads Rising

ASCs are paying more for nearly every staff position they hire and offering robust benefits packages to help manage increasing caseloads and employee turnover rates that exceeded 20 percent in more than one out of five surgery centers during 2022, data collected in ASCA’s 2023 Salary & Benefits Survey shows.


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Support Continues to Grow for Outpatient Surgery Quality and Access Act

This fall, three new cosponsors have joined the Outpatient Surgery Quality and Access Act of 2023 (H.R. 972/S. 312): Representatives Greg Murphy, MD (R-NC), Mariannette Miller-Meeks, MD (R-IA), and Greg Steube (R-FL).


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ASCA Advocacy Achieves Victories in 2024 Final Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released its 2024 final payment rule for ASCs and hospital outpatient departments on November 2. CMS added multiple procedures to the ASC Covered Procedures List that were not included in the proposed rule, including total shoulder arthroplasty.


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California Raises Minimum Wage for Healthcare Workers

On October 13, California Governor Gavin Newsom signed SB 525 into law. The bill increases the minimum wage for healthcare employees from $15.50 to $25 over a five-year period. ASCs will see their first wage increases effective June 1, 2024.


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ASCA Meets with CMS to Discuss 2024 Proposed Payment Rule

On Thursday, October 12, ASCA representatives met virtually with Doug Jacobs, MD, chief transformation officer of the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS). Ryan Howe, who serves as the acting director for the Center for Medicare’s Hospital & Ambulatory Policy Group, joined Jacobs in the meeting.


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ASCs Making an Effort to Be Price Transparent

In ASCA’s August 2023 60-Second Survey, 91 percent of survey respondents said that their facility has a standard workflow for providing estimates to patients prior to a procedure.


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Complying with DSCSA

In recent months, ASCA has received numerous questions regarding ASC compliance with regulations related to the Drug Supply Chain Security Act. ASCA’s best understanding of surgery center requirements as of September 2023 follows.


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National ASC Month in Review

Last month, ASCA members celebrated National ASC Month by hosting their members of Congress and their staff for facility tours during the August congressional recess.


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Comment Now on Medicare’s 2024 Proposed Rule

Submit your comments for the Centers for Medicare & Medicaid Services’ (CMS) 2024 proposed payment rule by September 11. ASCA will once again submit comments raising industry-wide concerns, but it is important that CMS hears from individual centers as well.


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ASCA Member Hosts Facility Tour during National ASC Month

Earlier this month, South Kansas City Surgicenter in Overland Park, Kansas, hosted a tour for Representative Sharice Davids (D-KS).


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New Surgical Smoke Evacuation Requirements to Kick In

New requirements on surgical smoke evacuation take effect January 1, 2026, in Missouri. Governor Mike Parson (R) signed HB 402 into law in July, enacting the new requirements for healthcare facilities in the state.


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Fazio Looks Forward to Working on Medicare Advisory Panel

Brandon Fazio, senior director of financial analysis of Ambulatory Surgery Centers at Community Health Systems in Franklin, Tennessee, says that he is looking forward to his first meeting, August 21–22, as a member of the Advisory Panel on Hospital Outpatient Payment (HOP).


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Analyzing CMS’ Proposed 2024 Updates to Medicare Physician Rates

In the proposed 2024 updates to the Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services (CMS) proposed a conversion factor (CF) of $32.7476 for 2024, which would represent a 3.36 percent decrease from the 2023 CF.


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HIPAA Biannual Update

During the first half of 2023, healthcare organizations across the country posted 322 breaches of protected health information (PHI) affecting 500 or more individuals. Consistent with previous updates, the vast majority of the breaches—96 percent—were caused by unauthorized access or hacking.


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CMS Releases 2024 Proposed Medicare Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2024 proposed payment rule for ASCs and hospital outpatient departments (HOPD) on July 13.


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National Health Expenditures Projected to Exceed $7 Trillion by 2031

The Centers for Medicare & Medicaid Services (CMS) Office of the Actuary recently released updated projections for national health expenditures (NHE) and health insurance enrollment in the US over the next decade.


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Sg2 2023 Annual Report Forecasts Significant Growth in ASC Volume

ASCs will see 12 percent and 22 percent growth in the next 5 and 10 years, respectively, according to Sg2’s 2023 Impact of Change Forecast Highlights.


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Accreditation Agencies Release ASC Top Deficiencies List

The Accreditation Association for Ambulatory Health Care (AAAHC), the Accreditation Commission for Health Care (ACHC), QUAD A and The Joint Commission have announced their lists of top deficiency areas that ASCs got citations for in 2022.


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UnitedHealthcare Requests Advance Notification for GI Procedures

ASCA and the health community’s efforts paid off with UnitedHealthcare (UHC) rescinding its controversial prior authorization policy implementation just as it was scheduled to take effect on June 1.


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CMS Withdraws COVID-19 Vaccination Mandate for Healthcare Personnel

On May 31, the Centers for Medicare & Medicaid Services (CMS) released a final rule that withdrew the regulations that mandated COVID-19 vaccination for healthcare personnel. This action, however, does not affect the ASC Quality Reporting (ASCQR) Program measure ASC-20: COVID-19 Vaccination Coverage Among Health Care Personnel.


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South Carolina Enacts Major Reform to Certificate of Need Law

South Carolina Governor Henry McMaster signed SB 164 into law in the middle of May, eliminating certificate of need (CON) requirements for almost all health facilities in the state, including ASCs but excluding nursing homes and the Medical University of South Carolina.


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More Legislators Sign On to Cosponsor Outpatient Surgery Quality and Access Act

The Outpatient Surgery Quality and Access Act of 2023 (H.R. 972/S. 312) has gained support from ASCA members’ advocacy efforts.


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ASCA 2023: A Winner, Hands Down

The ASCA 2023 Conference & Expo is in the homestretch in Louisville, Kentucky! The Kentucky International Convention Center (KICC) is abuzz with more than 1,900 attendees, including more than 180 exhibitors and 29 sponsors.


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ASCA Opposes Upcoming UnitedHealthcare Prior Authorization Policy

Beginning June 1, 2023, insurer UnitedHealthcare (UHC) will require providers to seek authorization before performing almost all upper gastrointestinal (GI) endoscopy, colonoscopy and capsule endoscopy procedures.


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ASCA Member Hosts Facility Tour for Congressional Staff

Earlier in April, 90210 Surgery Medical Center in Beverly Hills, California, hosted a facility tour for the staff of Representative Ted Lieu (D-CA). The conversation allowed the facility to discuss surgery centers with the congressman’s staff and the importance of supporting the Outpatient Surgery Quality and Access Act of 2023.


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ASCA, Ophthalmic Groups Meet With CMS Quality Reporting Staff

On April 13, ASCA staff met with senior leadership at the Centers for Medicare & Medicaid Services (CMS) to discuss concerns with the ASC Quality Reporting (ASCQR) Program, primarily focusing on ASC-11: Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery.


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Support Grows for ASC Legislation after National Advocacy Day

After meeting with a constituent during National Advocacy Day earlier this month, Representative Mike Bost (R-IL), former Illinois House of Representatives Republican caucus chair, firefighter and US Marine Corps corporal, signed up to be a cosponsor of the Outpatient Surgery Quality and Access Act of 2023 (H.R. 972/S. 312).


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Studies Show Potential Savings for Site-Neutral Payments

Two recent studies, along with ongoing work by the Medicare Payment Advisory Commission (MedPAC), show considerable savings potential for policies that align reimbursement for certain outpatient services at the level of the lowest cost setting, such as in ASCs.


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ASCA Survey Shows Limited Service of Medicaid Beneficiaries

In mid-February, ASCA conducted its first 60-Second Survey of 2023 and asked questions on payer mix, specifically ASCs’ current service levels of Medicaid beneficiaries.


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ASC Advocates Return to Capitol Hill during National Advocacy Day

Linda Bedwell, RN, CASC, director of Powder River Surgery Center in Gillette, Wyoming, recently participated in ASCA’s first National Advocacy Day in more than three years.


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New Research Shows Rapid Shift of Total Joint Surgeries to Outpatient

Thanks to advancements in medical techniques and devices, surgeons are performing an increasing number of total joint surgeries in the outpatient setting.


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Bill Sponsors Reintroduce Outpatient Surgery Quality and Access Act

Congressmen Brad Wenstrup, DPM (R-OH) and John Larson (D-CT) reintroduced the bipartisan, bicameral Outpatient Surgery Quality and Access Act of 2023 in the US House of Representatives (H.R. 972) and Senators Richard Blumenthal (D-CT) and Bill Cassidy, MD (R-LA) introduced the legislation in the US Senate (S. 312) last week.


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HIPAA Biannual Update

Since ASCA’s last update in August, healthcare organizations across the country posted 333 breaches of protected health information (PHI) affecting 500 or more individuals. Consistent with previous time periods, the vast majority of the breaches—95 percent—were caused by unauthorized access or hacking.


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After Delays, Federal E-Prescribe Mandate Takes Effect

The new federal requirements related to electronic prescribing (e-prescribing) of controlled substances went into effect on January 1, 2023. Any prescriber who issues more than 100 qualifying controlled substance prescriptions in a calendar year will be required to transmit at least 70 percent of prescriptions electronically in 2023.


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Offer ASCA Retirement Plan to Your Employees

When healthcare professionals consider their employment options, many factors likely influence the jobs they apply for and the jobs they remain at. One of the top influencers is typically salary, but increasingly not far below in significance when evaluating employment opportunities is benefits, says Michael Cournyea, chief executive officer of Atlas Surgery Center in Williamsville, New York.


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ASCs Resume Data Collection for ASC-1 through ASC-4

At the beginning of this month, the Centers for Medicare & Medicaid Services (CMS) resumed data collection for four outcomes measures in the ASC Quality Reporting (ASCQR) Program.


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ASC Quality Reporting Program Requirements Change in 2023

On January 1, 2023, ASCs will need to resume collecting data for four outcomes measures in the ASC Quality Reporting (ASCQR) Program: ASC-1: Patient Burn; ASC-2: Patient Fall; ASC-3: Wrong Site, Wrong Side, Wrong Patient, Wrong Procedure, Wrong Implant; and ASC-4: All-Cause Hospital Transfer/Admission.


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ASCA’s National Advocacy Day Returns after Three Years

The deadline to apply for ASCA’s National Advocacy Day Scholarship for next year will close Friday, December 30. ASCA will award up to five scholarships of up to $1,000 each. Interested members who find the participation expenses prohibitive are encouraged to apply.


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Reintroducing ASC Legislation in the 118th Congress

With the Georgia Senate runoff coming to a close on December 6, the long drawn-out 2022 midterm cycle has finally ended, and it is time to take a look at ASCA’s legislative priorities going into 2023.


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Analyzing CMS’ 2023 Final Medicare Rule

In its 2023 final payment rule for ASCs and hospital outpatient departments (HOPD), the Centers for Medicare & Medicaid Services (CMS) showed a willingness to advance policies that will drive volume to the ASC setting and save Medicare and its beneficiaries money.


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Effects of No Surprises Act in Year One

Per the No Surprises Act (NSA), the US Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) will begin enforcing the full scope of good faith estimates (GFE)—the inclusion of data elements from co-providers and co-facilities—on January 1, 2023. ASCs will likely most often be considered a co-facility.


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CMS Releases 2023 Final Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2023 final payment rule for ASCs and hospital outpatient departments (HOPD) on November 1.


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ASC-20 Deadline Less than Two Weeks Away

The second data submission deadline for ASC-20: COVID-19 Vaccination Coverage Among Health Care Personnel is Tuesday, November 15. This deadline is for submitting the data collected in the second quarter of 2022, April 1 through June 30.


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Illinois Ends its Healthcare Worker COVID-19 Vaccination Mandate

The COVID-19 vaccination and testing requirements for healthcare workers in Illinois expired on October 14. Governor J.B. Pritzker issued an executive order on that day to reissue and extend previously issued COVID-19 executive orders, but he did not extend the healthcare worker vaccination and testing requirements established by another executive order in September 2021.


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Winding Down Hospitals Without Walls

ASCs still operating as hospitals as part of the Hospitals Without Walls program should evaluate their continued participation as states are ending, or have already ended, their emergency/pandemic plans related to COVID-19 and are returning to normal status.


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Wyoming ASC Hosts Open House

Powder River Surgery Center in Gillette, Wyoming, opened its doors for an open house event recently, as part of National ASC Month. Out of the 20 surgery centers in the state, Powder River was the only ASC to host an open house in Wyoming.


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ASCA Survey Shows Dramatic Increases in Drug and Supply Costs

ASCA conducted its ninth 60-Second Survey and asked questions about medical supply and drug price changes over the past year. The survey, conducted last month, received 139 responses from facilities in 39 states and one respondent from the US Virgin Islands.


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Louisiana Tweaks Written Transfer Agreement Requirement

The Louisiana Department of Health’s Bureau of Health Services Financing finalized changes to the state’s transfer agreement and patient transfer requirements for ASCs a few weeks back. The final rule tweaked the state’s written transfer agreement requirement but did not align it with the Centers for Medicare & Medicaid Services (CMS) requirements adopted in 2019, as other states have.


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Illinois Aligns with CMS’ Burden Reduction Changes

While states have moved slowly to align with the Centers for Medicare & Medicaid Services’ (CMS) 2019 burden reduction changes, 2022 has seen an uptick in action on the issue. Three states have made changes this year: Alaska, Illinois and Ohio.


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Comment Now on 2023 Medicare Proposed Rule

The deadline to submit comments on the Centers for Medicare & Medicaid Services’ (CMS) 2023 proposed payment rule for ASCs and hospital outpatient departments (HOPD) is Tuesday, September 13. ASCA will once again submit comments raising industry-wide concerns, but it is important that CMS hears from individual centers as well.


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HIPAA Biannual Update

Since ASCA’s last update in January, healthcare organizations across the country posted 337 breaches of protected health information (PHI) affecting 500 or more individuals.


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Pennsylvania Enacts Major Update to Allowable Procedures in ASCs

Beginning September 9, ASCs in Pennsylvania will not be required to submit waivers to perform common procedures routinely performed in ASCs in other states, such as total joint procedures, laparoscopic procedures, laparoscopic cholecystectomy procedures, and dialysis and vascular access procedures.


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ASCQC Annual Meeting Returns In Person

The ASC Quality Collaboration (ASCQC) held its seventh annual ASC Quality Conference in the last week of July in Franklin, Tennessee. Kathy Wilson, RN, executive director of ASCQC, discussed the meeting with ASC Focus. Below are excerpts from an interview.


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Analyzing CMS’ 2023 Proposed Medicare Payment Rule

The Centers for Medicare & Medicaid Services (CMS) proposed a new complexity adjustment payment mechanism for ASCs in its 2023 proposed payment rule for ASCs and hospital outpatient departments (HOPD), which, if adopted, will provide Medicare beneficiaries better access to care.


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ASCA Survey Gives Insight into ASC Staffing

In June, ASCA conducted its eighth 60-Second Survey and asked questions about staff hourly rates, use of contracted personnel and staff turnover in the last year. The survey received 314 responses, one of the highest participation rates since the series began.


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Dental Associations Urge CMS to Add Codes to ASC-CPL

For years, ASCA has worked with key dental organizations to add dental surgery procedures to the Centers for Medicare & Medicaid Services’ (CMS) ASC Covered Procedures List (ASC-CPL). These procedures cannot be performed in an ASC because they do not have codes payable under Medicare Part B.


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ASC-20 Reporting Deadline Approaching Quickly

The Centers for Disease Control and Prevention (CDC) recently updated its reporting guidance for ASC-20: COVID-19 Vaccination Coverage Among Health Care Personnel (HCP), including the definition of what it means for an individual to be “up to date” with vaccinations. This change became effective with reporting beginning the week of June 27.


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CMS Updates ASC Guidance for Surveyors

The Centers for Medicare & Medicaid Services’ (CMS) updates to the State Operations Manual (SOM) Appendix L - Guidance for Surveyors: Ambulatory Surgical Centers make conforming revisions to the regulatory tags and interpretive guidelines, as well as clarifications and technical corrections to other guidance areas based on stakeholder feedback.


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ASCA Members Host Facility Tours

Earlier in June, two ASCA members—Tallgrass Surgical Center in Topeka, Kansas, and Emmaus Surgical Center in Hackettstown, New Jersey—invited their members of Congress to visit their surgery centers.


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Sg2 Annual Report Projects Double-Digit ASC Growth

ASCs will see 15 percent and 25 percent growth in the next 5 and 10 years, respectively, according to Sg2’s 2022 Impact of Change Forecast Highlights.


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Trend Emerges in CMS Citations

The Centers for Medicare & Medicaid Services' (CMS) Quality, Certification and Oversight Reports (QCOR) page allows the public to pull citation frequency reports for both health surveys and Life Safety Code surveys.


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How Connecticut Repealed its ASC Gross Receipts Tax

Now that Connecticut has repealed the state’s ASC gross receipts tax, the Connecticut Association of Ambulatory Surgery Centers (CAASC) has a moment to rejoice and look back at the long road it took to get to this point.


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ASCA Survey Respondents Provide Preferences for Educational Events

ASCA conducted its seventh 60-Second Survey in April and asked questions regarding preferences for ASCA educational events, such as the annual conference and winter seminars. The survey received 180 responses.


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Nurse’s Criminal Conviction Raises Concerns for Healthcare Providers

The RaDonda Vaught verdict has healthcare providers, including many in ASCs, on edge as they contemplate its effects on staffing shortages and their own lives.


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ASCA 2022 in Full Swing

After two years of virtual events, the ASCA 2022 Conference & Expo in Dallas, Texas, is back in person and wraps up tomorrow. The Gaylord Texan Resort & Convention Center is abuzz with 1,940 participants, 179 exhibiting companies and 24 sponsors.


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President Biden’s Proposed FY 2023 Budget Could Affect ASCs

In President Biden’s proposed budget for 2023 federal spending, Medicare Part B fee-for-service (FFS) spending, which covers physician services, outpatient hospital services and ASCs among other programs, is expected to total $227.7 billion in 2023 alone.


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ASCA Advocates for More Codes to be Added to ASC-CPL

On March 17, ASCA staff met virtually with the Centers for Medicare & Medicaid Services (CMS) staff responsible for payment policies in ASCs. At the meeting, the participants discussed mainly the ASC Covered Procedures List (ASC-CPL).


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ASCA Survey Shows Use of Varied Marketing Strategies

In February, ASCA conducted its sixth 60-Second Survey and asked questions regarding ASC facility marketing and resources that ASCA might be able to provide. The survey received 141 responses.


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New Data Confirms Orthopedic Surgery Costs Less in ASCs

A new research article published in the March 2022 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) shows low costs for orthopedic surgery at ASCs compared to hospital outpatient departments (HOPD) even as utilization of ASCs increases.


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States Move Slowly to Align with CMS Changes

Only two states, Alaska and Delaware, have adapted their state laws to match the changes made by the Centers for Medicare & Medicaid Services (CMS) in 2019. Louisiana is currently considering a proposed regulation that would partly bring the state in line with CMS changes.


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How to Report ASC-20 Accurately

In the 2022 OPPS/ASC final payment rule, regarding the ASC Quality Reporting (ASCQR) Program, the Centers for Medicare & Medicaid Services (CMS) finalized its proposal to “Adopt ASC-20: COVID-19 Vaccination Coverage Among HCP [Health Care Personnel] measure beginning with the CY 2024 payment determination.”


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States Fight CMS over COVID-19 Vaccination Mandate

On February 9, a judge in the US District Court for the Western District of Louisiana told a coalition of 16 states that he does not have the jurisdiction to grant a preliminary injunction against implementation of the Centers for Medicare & Medicaid Services (CMS) healthcare worker COVID-19 vaccination mandate in those states’ jurisdictions.


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HIPAA Biannual Update

Since ASCA’s last update in July, healthcare organizations across the country posted 331 breaches of protected health information (PHI) affecting 500 or more individuals. Consistent with previous time periods, the vast majority of the breaches—95 percent—were caused by unauthorized access or hacking.


Read More >

 


CMS Healthcare Worker Vaccination Mandate Moves Closer to Finish Line

In a 5-4 decision on January 13, the US Supreme Court handed down an opinion allowing the Centers for Medicare & Medicaid Services (CMS) to move forward with the implementation of its healthcare worker vaccination mandate while the cases of Biden v. Missouri and Becerra v. Louisiana continue to move through appellate courts.


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ASCA Survey Shows Extent of Staffing Issues

In March 2021, ASCA introduced a bimonthly survey series named 60-Second Survey. The fifth survey, conducted in December 2021, asked questions regarding nursing and other staff shortages. The survey received 338 total responses.


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Provisions Related to Surprise Medical Billing Become Effective in New Year

On January 1, 2022, much of the No Surprises Act goes into effect, including provisions pertinent to ASCs, such as the requirement to provide a good faith estimate to uninsured and self-pay individuals.


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States Take Steps to Allow Cardiac Procedures in ASCs

State laws and regulations governing the performance of percutaneous coronary intervention (PCI) procedures—a type of cardiac catheterization service—still pose a major obstacle in ASCs performing the procedures despite the addition of three PCI procedures—CPT codes 92920 and 92928 and HCPCS code C9600—along with three associated add-on procedures—CPT codes 92921 and 92929 and HCPCS code C9601—to the ASC Covered Procedures List (ASC-CPL).


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ASC Legislation to Help Level the Playing Field for Outpatient Surgery

In early November, elected officials in both the US House of Representatives and the US Senate introduced the Outpatient Surgery Quality and Access Act of 2021 (H.R. 5818 and S. 3132). Representatives John Larson (D-CT) and Devin Nunes (R-CA) introduced the legislation in the House and Senators Richard Blumenthal (D-CT) and Bill Cassidy, MD, (R-LA) introduced it in the Senate.


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Analyzing CMS’ 2022 Final Medicare Payment Rule

In its 2022 final payment rule for ASCs and hospital outpatient departments (HOPD), the Centers for Medicare & Medicaid Services (CMS) finalized its proposal to reverse policy changes from the previous administration that added a significant number of codes to the ASC Covered Procedures List (ASC-CPL) and began the process of eliminating the inpatient-only (IPO) list, with a few modifications.


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Bundling Up Care

Ambulatory Surgical Center of Stevens Point in Stevens Point, Wisconsin, recently entered into an agreement to participate in Trilogy Health Solutions’ workers’ compensation cost-containment solution, WC Bundled Payments.


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ASCA Survey Signals Interest in Return to In-Person Events in 2022

In March 2021, ASCA introduced a bimonthly survey series named 60-Second Survey. The fourth survey, conducted in October 2021, asked questions regarding ASCA membership and ASC business/education travel in 2022, and received 136 responses.


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State Legislative Trends in 2021

After state legislatures spent 2020 grappling with the COVID-19 pandemic, 2021 saw states dedicating more time to addressing issues not directly related to the pandemic, though legislation related to the pandemic still featured heavily on dockets.


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States Face Lawsuits Over Lack of Religious Exemptions in Vaccine Mandates

Over the course of the late summer, states across the country grappled with a resurgence of the COVID-19 pandemic, driven largely by the Delta variant and exacerbated by a slowdown in new vaccinations. Hospitals and health systems once again faced shortages of ICU beds and a few states began looking for additional tools to curb the newest wave of infections.


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ASCs versus HOPDs

As discussed in last week’s Digital Debut, the Centers for Medicare & Medicaid Services (CMS) argued in the proposed payment rule that “while there are similarities between the ASC and hospital outpatient department (HOPD) settings, there are also significant differences between the two care settings.”


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ASCA Comments on Medicare’s 2022 Proposed Payment Rule

Last week, ASCA submitted its comments in response to the calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (“Proposed Rule”) (86 Fed. Reg. 42018, August 4, 2021).


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Biden Administration Proposes Physician Medicare Policies for 2022

On July 13, the Centers for Medicare & Medicaid Services (CMS) released CY 2022 proposed updates to the Medicare Physician Fee Schedule (MPFS) and other related Part B payment policies.


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ASCA’s Latest Podcast Episode Discusses Hospitals Without Walls Program

In the newest episode of ASCA’s Advancing Surgical Care Podcast, “A Closer Look at Hospitals Without Walls,” Kara Newbury, ASCA’s regulatory counsel and director of Government Affairs, and Bill Prentice, ASCA’s chief executive officer, discuss the program’s first year, evaluate what worked and what did not and consider the future and long-term effects of this initiative.


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States Mandate COVID-19 Vaccine as Delta Surges

As the Delta variant of the COVID-19 virus sweeps across the country, hitting unvaccinated populations hard and resulting in severe spikes in hospitalizations, many states have sought additional tools in their fight against this most recent wave.


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Salaries Rise, Hiring Increases Expected at Majority of ASCs

Salaries for nearly every position in an ASC continued to trend upward this year, according to data collected in ASCA’s 2021 Salary & Benefits Survey. Most ASCs reported budgeting 3 percent salary increases for both hourly and salaried staff, and 71 percent of ASCs projected a hiring increase in 2021.


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New Research Shows ASC Growth Slowed After 2008 Medicare Changes

On July 27, researchers from the University of Louisville and Baylor University, Elizabeth L. Munnich and Michael R. Richards, published a research brief, Long-run growth of ambulatory surgery centers 1990–2015 and Medicare payment policy, in Health Services Research.


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CMS Releases 2022 Proposed Medicare Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2022 proposed payment rule for ASCs and hospital outpatient departments (HOPD) on July 19, 2021.


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HIPAA Biannual Update

Since ASCA’s last update in January, healthcare organizations across the country posted 344 breaches of protected health information (PHI) affecting 500 or more individuals. This is the highest number of breaches reported in a six-month span in the past three years and exceeds the number of breaches in the first half of 2020 by more than 40 percent.


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HHS Releases Surprise Medical Billing Interim Final Rules

The US Departments of Health & Human Services (HHS), Labor, and the Treasury, and the Office of Personnel Management issued “Requirements Related to Surprise Billing; Part I” on July 1, 2021. The deadline to comment on this interim final rule (IFR) is September 7, 2021.


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Connecticut Overhauls ASC Gross Receipts Tax

Connecticut Governor Ned Lamont (D) signed the two-year state budget implementer bill, SB 1202, into law a couple of weeks ago. The budget implementer contained policy provisions impacting various state laws, including one with big implications for ASCs: an advantageous overhaul of the state’s ASC gross receipts tax.


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Provider Relief Fund Reporting Period Opens July 1

On July 1, the US Department of Health & Human Services (HHS) opened the reporting portal for all healthcare providers, including ASCs, that received Provider Relief Fund (PRF) grants exceeding $10,000 in aggregate. These grants were administered by HHS through the Health Resources & Services Administration (HRSA).


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OSHA Emergency Temporary Standard Takes Effect Soon

On Thursday, June 10, the Occupational Safety and Health Administration (OSHA) announced COVID-19 Emergency Temporary Standard (ETS) requirements for frontline healthcare workers. The ETS was published in the federal register on Monday, June 21, and affected facilities must be in compliance with the new ETS either 14 or 30 days after publication.


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Sg2 Releases ‘2021 Impact of Change’ Report

Hospital outpatient departments (HOPD) and ASCs will continue to experience rapid patient growth—19 percent and 25 percent by 2029, respectively—experiencing a patient volume that is 15 million higher in 2029 than in 2019, according to “2021 Impact of Change Forecast Highlights,” a report from Sg2, a healthcare industry analyst, released on June 4.


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ASCA Survey Shows Mixed Usage of EHR among ASCs

In late April 2021, ASCA conducted the second survey in its new, bimonthly survey series named 60-Second Survey. Each survey asks fewer than 10 questions on a current topic and takes approximately a minute to complete.


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ASCA Releases New Podcast Episode on Facility Design Guidelines

ASCA interviewed David Shapiro, MD, former president and current Board member of ASCA and a member of the board of directors of the Facility Guidelines Institute (FGI) in the latest episode of ASCA’s Advancing Surgical Care Podcast.


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ASCA Refines its Facility Tour Program

ASCA has begun its 2021 facility tour program. This year’s program builds upon the changes that ASCA staff made to the program last year to adapt to the COVID-19 pandemic.


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ASCs Face Challenges in Electronic Prescribing Requirements

Since the first state electronic prescribing requirement came into effect in 2011 in Minnesota, most states have followed suit. By the end of 2021, 31 states will have laws in effect requiring electronic prescribing by healthcare providers.


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Input Your Quality Data Correctly

The ASC Quality Reporting (ASCQR) Program data submission deadline is rapidly approaching on May 17, 2021. Not quite ready to report? Please review our last Digital Debut article to walk you through the registration process.


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ASCQR Deadline Looms Large

On a call with ASC Quality Reporting (ASCQR) Program support staff last week, ASCA staff learned that 2,000 ASCs still have not registered to report their Medicare quality data and the registration process can take several weeks. The reporting deadline is May 17, 2021.


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Medicare Sequestration Cuts Suspended Until End of Year

On April 14, President Joe Biden signed H.R. 1868 into law. This legislation will extend the suspension of 2 percent sequestration cuts to Medicare reimbursement through the end of the year.


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CMS Changes to Payable Lists Causes Confusion

The Centers for Medicare & Medicaid Services (CMS) made significant changes to the surgical codes that can be performed in hospital outpatient departments (HOPD) and ASCs in the calendar year (CY) 2021 Outpatient Prospective Payment System (OPPS)/ASC final payment rule.


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ASCA Survey Confirms Operational Impacts of Pandemic on ASCs

On March 3, ASCA introduced a bimonthly survey series named 60-Second Survey. The first survey asked about operational impacts of the COVID-19 pandemic in 2020 and received 314 responses in 10 days. Responses were recorded from ASCs in 44 different states.


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ASCAPAC Kicks Off Annual State Competition

Each year, ASCAPAC, ASCA’s nonpartisan political action committee (PAC) and the only federal PAC that represents the interests of all ASCs, asks ASC leaders in each state to help ASCAPAC achieve its potential and amplify the voice of the ASC community in Washington. DC.


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Medicare Payment Policy Advocacy for 2022 and Beyond

On March 1, ASCA Board President Michael Patterson and ASCA staff met virtually with the Centers for Medicare & Medicaid Services staff responsible for payment policies in ASCs.


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SD House Taxation Committee Votes to Defeat ASC Tax Legislation

In the beginning of this month, South Dakota House Majority Whip Tim Goodwin (R) introduced HB 1246, which if enacted would have imposed a new tax on ASCs, set at 6 percent of gross receipts.


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One-on-One with an ASCA Board Member

Amanda Hawkins, CASC, director of The Surgery Center of Charleston in Charleston, South Carolina, joined the ASCA Board of Directors in 2019. She will serve a three-year term.


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Getting the Maximum Value of Relief from PPP

As the world approaches different one-year anniversaries involving the coronavirus pandemic, on the ASCA advocacy front, we celebrate many discrete moments of importance and milestones from 2020.


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ASC Set to Help Local Hospital during COVID-19 Surge

As access issues heighten during the COVID-19 pandemic, hospitals in communities across the country are limiting nonurgent procedures. Consequently, ASCs, such as the Powder River Surgery Center in Gillette, Wyoming, are preparing to accommodate surgical patients from their hospital partners.


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HIPAA Biannual Update

Since ASCA’s last update in July, healthcare organizations across the country posted 324 breaches of protected health information (PHI) affecting 500 or more individuals. This is the highest number of breaches reported in a six-month span in the past three years and exceeds the number of breaches in the first half of 2020 by almost 40 percent.


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Review of the Last Quarter of the 116th Congress

With many members of Congress curtailing their in-person events and meetings during the pandemic and many ASCs operating under tight new safety constraints, ASCA created a virtual tour program so that members could maintain contact with their federal representatives.


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ASC QC COVID-19 Survey Confirms Continued Safety in ASCs

As part of its mission to support the collection and reporting of quality data, the ASC Quality Collaboration (ASC QC) conducted a survey of more than 700 ASCs during the early days of the COVID-19 pandemic when surgeries were limited to urgent and emergent cases.


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Takeaways From Medicare's 2021 Final Payment Rule

The most significant change for ASCs in the 2021 final payment rule for ASCs and hospital outpatient departments (HOPD) is the addition of 267 codes to the ASC Covered Procedures List (ASC-CPL), including total hip arthroplasty (THA), and the changes made to the Code of Federal Regulations (CFR) section allowing for this change.


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ASC Community Welcomes CMS’ Change to HWOW Nursing Requirement

The Centers for Medicare & Medicaid Services' (CMS) recent change to the 24-hour nursing services requirement in its Hospitals Without Walls (HWOW) program will possibly encourage more ASCs to participate in the program.


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CMS Releases 2021 Final Medicare Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2021 final payment rule for ASCs and hospital outpatient departments (HOPD) on December 2.


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ASC Community Suffers Tragic Loss

Ann Shimek, RN, CASC, senior vice president and chief clinical officer at Surgery Partners, passed away on November 25.


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Majority of ASC Supporters Retain Their Congressional Seats

While the November 3 general election has not yet provided a definitive answer on which party will control the United States Senate and a number of races remain outstanding in the US House of Representatives, the general contours of the election and its results are clear.


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Federal Government Warns of Cybercrime Threat to Healthcare Providers

Federal agencies, including the Federal Bureau of Investigation and the US Department of Health & Human Services, issued a warning last week on an "increased and imminent cybercrime threat to US hospitals and healthcare providers."


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One World Surgery Needs Volunteer Consults

Like the rest of the world, the COVID-19 pandemic has impacted Honduras and the Dominican Republic (DR), the two countries where One World Surgery (OWS) sends its medical mission teams.


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HHS Releases Reporting Requirements for Provider Relief Fund Recipients

Last month, the US Department of Health & Human Services (HHS) published the Post-Payment Notice of Reporting Requirements and a summary of reporting requirements for Provider Relief Fund (PRF) recipients.


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ASCA Members Host Virtual Facility Tours

Despite the unprecedented challenges presented by the COVID-19 pandemic, ASCA and its members have adapted to continue their vital advocacy efforts. In August, ASCA rolled out its virtual tour program, which replaced the in-person facility tours.


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ASCs Reduce Medicare Costs by More than $4 Billion Each Year

ASCA released a new analysis of Medicare payment data this week that shows performing outpatient surgery procedures in ASCs, instead of in higher-cost hospital outpatient departments (HOPD) from 2011 through 2018, saved Medicare $28.7 billion.


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Nebraska Changes Length of Stay Requirement

Come November 14, a revised length of stay requirement will take effect in Nebraska ASCs. Governor Peter Ricketts (R) signed LB 783 into law last month to make Nebraska the 29th state to successfully update its length of stay hours to match the Centers for Medicare & Medicaid Services’ (CMS) length of stay requirement for ASCs.


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ASCA Advocates for Non-Taxable Federal Aid for COVID-19

For many ASCs, money from the Provider Relief Fund has been an important source of relief during the trying financial times tied to the COVID-19 emergency. This monetary assistance, however, comes with strings attached. Under current rules, ASCs that accepted aid from the Provider Relief Fund will face tax implications related to that assistance next year.


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CMS Resumes Surveys After COVID-19 Lockdown

The Centers for Medicare & Medicaid Services (CMS) announced earlier this month that it would expand survey operations for all CMS-certified providers and suppliers after the months-long suspension of “certain routine inspections as part of its response to the coronavirus disease 2019 (COVID-19) pandemic to prioritize infection control and immediate jeopardy situations and to give health care providers and suppliers time needed to respond to the spread of COVID-19.”


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ASCs Face Post-Lockdown Staffing Challenges

As ASCs settle in after being back from the COVID-19 lockdown, they are reporting various personnel concerns. The Surgicenter of Kansas City (SCKC) in Kansas City, Missouri, is seeing a higher case volume, says Janie Kinsey, RN, CASC, ASCA Board member and administrator of the ASC.


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Proposed Rule Aligns With ASCA Asks

ASCs can be optimistic about the 2021 proposed payment rule for ASCs and hospital outpatient departments (HOPDs) that the Centers for Medicare & Medicaid Services (CMS) released last week. The tone of the rule was positive toward ASCs and a common thread running through was a recognition that physician decision-making is the best arbiter for determining the appropriate setting for beneficiary care.


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HIPAA Biannual Update

Since ASCA’s last update in January, healthcare organizations across the country posted 233 breaches of protected health information (PHI) affecting at least 500 individuals. Consistent with previous time periods, most of the breaches—86 percent—were caused by unauthorized access or hacking.


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Holding Facility Tours in the Time of COVID

Traditionally, ASCs hosted facility tours in the month of August and invited their federal representatives for in-person tours. The coronavirus pandemic, however, has changed that approach to facility tours and the way ASCs celebrate National ASC Month.


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ASCA Honors Industry Stalwarts

ASCA named Bill Wilcox, retired vice chairman of Tenet Healthcare Corporation in Dallas, Texas, and retired chairman and chief executive officer of United Surgical Partners International (USPI) in Addison, Texas, and Randy Leffler, the recently deceased executive director of the Ohio Association of Ambulatory Surgery Centers, as the recipients of its 2020 Nap Gary Legacy Award for Lifetime Achievement in the ASC Community.


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ASCA 2020 Creates Online Buzz

ASCA’s annual conference made its virtual debut yesterday with the first day of the ASCA 2020 Virtual Conference & Expo. Attendees can access nearly 50 educational sessions, two keynote addresses, 17 affiliate presentations and five focus groups and interact with the sponsors and exhibitors at the conference.


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Understanding COVID-19 Federal Aid Programs

During the pandemic your ASC might have relied on financial support from federally administered programs, like the Paycheck Protection Program (PPP) from the Small Business Administration (SBA) or Provider Relief Fund from the US Department of Health and Human Services (HHS).


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Managing Drug Supplies Effectively during COVID-19 Pandemic

Complications surrounding drug shortages stemming from the COVID-19 pandemic continue to emerge. Last month, the US Food & Drug Administration (FDA) issued an emergency use authorization (EUA) allowing the emergency use of Fresenius Propoven 2 percent (propofol 20 mg/ml) Emulsion 100 ml, an unapproved drug.


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Consequences of Delaying Elective Surgeries

As the COVID-19 lockdown eases across the US, 39 states have now issued orders or guidance allowing for the resumption of elective procedures; Hawaii remains the last state to have an ongoing executive order halting elective procedures, which expires at the end of June.


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CMS Considers Including ASCs in Bundled Payment Models

The deadline to submit comments on how to design a joint replacement model that incorporates ASCs as participants in the Comprehensive Care for Joint Replacement (CJR) bundled payment model is approaching fast. Interested parties may submit comments until 5:00 pm ET on June 23.


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Understanding PPP Loan Forgiveness

The US Small Business Administration (SBA) issued two interim final rules on May 22. The first focuses on Paycheck Protection Program (PPP) loan forgiveness, and the second on procedures for SBA’s review of loans and responsibilities for lenders and borrowers.


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ASCs Reopen Across the Country

As governors in multiple states lift stay-at-home restrictions, ASCs resume operation after being temporarily shut down or performing emergent surgeries only with minimal staff.


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Joining Forces Against COVID-19 Pandemic

As COVID-19 continues to ravage the US, healthcare workers across the country face shortages of personal protective equipment (PPE) and medical gear needed to treat patients.


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Flexibility and Rolling With Changes the Focus of ASCs While Reopening

ASCs in multiple states—Alabama, Arizona, Arkansas, Colorado, Indiana, Iowa, Louisiana, Mississippi, North Carolina, Ohio, Oregon, Pennsylvania, South Dakota, Tennessee, Virginia and West Virginia—resumed operation the week of April 27, 2020.


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CMS, ASCA, Accrediting Organizations Release Guidance

The Centers for Medicare & Medicaid Services (CMS) released guidance April 19 on restarting non-emergent non-COVID-19 healthcare.


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FDA Updates Extended Use Drugs List to Meet COVID-19 Demands

In light of the COVID-19 pandemic and the consequent demand for certain medications, the US Food & Drug Administration (FDA) updated its list of extended use drugs on April 3.


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ASCA CEO Discusses Expanding COVID-19 Response Under Federal Emergency Rules

ASCA Chief Executive Officer Bill Prentice talks about the temporary waivers and new rules that the federal government announced on March 30, 2020, expanded ways ASCs can support the COVID-19 response, and how surgery centers can access the federal assistance.


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Prevent Colorectal Cancer

March is National Colorectal Cancer Awareness Month, and ASCA is raising awareness about the importance of colorectal cancer screening and treatment.


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ASCs Implement COVID-19 Safety Measures

As the country battles the COVID-19 pandemic, ASCs across the nation have changed their policies and established new protocols to keep their patients and facilities safe.


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ASCA CEO Discusses COVID-19

As the nation reels under the COVID-19 pandemic, ASCA Chief Executive Officer Bill Prentice talks about its fallout on the healthcare system, protocols and guidelines, and what ASCs could expect going forward.<


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NOPAIN Act Gains Foothold

In the last week of February, the House Bipartisan Opioid Task Force published its agenda for the year. This agenda includes several bills, including the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, H.R. 5172, that the task force recommends the House of Representatives act on.


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February State Bills in Motion

The end of February officially marks the shift away from introduction of high volumes of new bills in the states to consideration of these proposals. With all but Arkansas, Louisiana and North Carolina having started their sessions by the end of February, March will bring more committee hearings, amendments and floor votes as the states work through the thousands of bills that have been introduced since the start of the year.


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Celebrate National Advocacy Day

ASCA will host National Advocacy Day on March 24 and 25 in Washington, DC. National Advocacy Day is one of the cornerstones of ASCA’s advocacy program, giving ASC professionals the chance to meet with their members of Congress and educate them about the issues facing ASCs in their states and communities.


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Keep Your Eye on These January Bills

Several states introduced legislation that are consequential to ASCs in the first month of the year. Thirty-six states had convened their legislative sessions and 30 governors had delivered state of the state addresses by the end of January, laying out their plans and priorities for the coming legislative year.


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Texas Cardiologist Discusses Procedures in the ASC Setting

As part of ASCA's new Asked & Answered online series, Donald Cross, MD, of Waco Cardiology Associates in Waco, Texas, discusses the scope of cardiology in outpatient settings.


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In Memoriam

The ASC community lost one of its valuable members last month. Randy Leffler, 51, executive director of the Ohio Association of Ambulatory Surgery Centers (OAASC), passed away on December 23, 2019.


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HIPAA Biannual Update

Since ASCA’s last update in July, healthcare organizations across the country posted 241 breaches of protected health information (PHI) affecting 500 or more individuals. This is the highest number of breaches reported in a six-month span in the past three years and exceeds the number of breaches in the first half of 2019 by more than 12 percent.


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Looking Ahead at 2020 Legislative Sessions

Now that the holiday season has wrapped up and 2019 has come to a close, states are preparing to convene their 2020 legislative sessions. Forty-six states will hold a legislative session this year, with Montana, Nevada, North Dakota and Texas not meeting in 2020. Thirty-eight states will convene their sessions in January, six—Alabama, Connecticut, Minnesota, Oklahoma, Oregon and Wyoming—will convene in February and two—Louisiana and Arkansas—will convene in March and April, respectively.


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CMS Finalizes New Hospital Price Transparency Requirements

On November 15, the US Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced a final rule aimed at increasing healthcare price transparency.


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Continuing Resolution Averts Government Shutdown

On November 21, the president signed into law legislation that provides temporary funding for the federal government and avoided a government shutdown that could delay Medicare payments and affect ASCs. This was the second of such bills, in the form of a continuing resolution (CR) that Congress passed and the president signed this fall.


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ASCA Meets with CMS Survey and Certification and Clinical Standards Staff

On November 18, ASCA staff met with representatives from the Centers for Medicare & Medicaid Services (CMS) Survey and Certification Group and Clinical Standards Group. The conversation centered around the recent finalization of CMS’ burden reduction rule that goes into effect on November 29, and how those changes impact ASCs.


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CMS Releases 2020 Final Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2020 final payment rule for ASCs and hospital outpatient departments (HOPDs) on November 1, 2019. The rule finalizes the addition of eight codes to the ASC-payable list, including total knee arthroplasty (TKA), which were previously not payable in the ASC setting.


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Colorado Anesthesiologist Discusses Non-Narcotic Pain Management

As part of ASCA's new Asked & Answered online series, Sundar Rajendran, MD, an anesthesiologist in Colorado Springs, Colorado, for the past 20 years, discusses the use of nerve blocks for non-narcotic based postsurgical pain management.


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Leapfrog Releases Preliminary Findings from ASC Survey

Preliminary results from The Leapfrog Group’s ASC Survey are in and include findings from data that 321 ASCs and 1,141 hospital outpatient departments (HOPD) submitted prior to August 31, 2019.


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Use Research to Drive ASC Advocacy

Facts- and data-based studies that show ASCs provide high-quality and low-cost care make for a powerful tool to educate legislators. For example, in September, 60 ASCA members from 15 different states participated in ASCA’s National Advocacy Day.


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Members Make National Advocacy Day a Success

Every year, ASCA members participate in a fly-in to Washington, DC, as part of National Advocacy Day. The program helps ASCA members build relationships with the policymakers who make the decisions that directly impact the ASC community and its patients.


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CMS Finalizes Sweeping Changes Aimed at Reducing Regulatory Burdens

On September 25, the Centers for Medicare & Medicaid Services (CMS) announced a final rule to relieve burden on healthcare providers by “removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements for healthcare providers and suppliers.”


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Two Legislative Developments and Their Significance to ASCs

In the August 2019 issue of ASC Focus, the column “Passing Bills” covered factors that contribute to the pace at which Congress considers and passes legislation. Since the publication of that article, there have been two major developments on the legislative front.


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Advanced Endoscopy Center Hosts Congressman

On September 4, the Advanced Endoscopy Center (AEC) hosted US Congressman Adriano Espaillat (NY-13) at its Bronx center as part of National ASC Month.


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Calling for Input on Medicare’s 2020 Proposed ASC Payment Rule

ASCA needs your input in response to the Centers for Medicare & Medicaid Services’ (CMS) 2020 proposed ASC payment rule. ASCA will submit comments raising industry-wide concerns, but it is important that CMS hears from individual centers as well, so that the agency understands how the policy changes impact your facility.


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ASCA CEO Discusses Medicare’s Proposed 2020 ASC Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released its 2020 proposed payment rule for ASCs and hospital outpatient departments (HOPD) on July 29, 2019. ASCA Chief Executive Officer Bill Prentice talks about the changes Medicare is proposing and their expected impact on ASCs.


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How to Correctly Code and Bill for Premium IOLs

Several compliance issues could come up with the use of intraocular lenses (IOL) used in cataract cases performed on Medicare patients in ASCs. These compliance issues involve the use of premium lenses.


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ASCQC Conference Shows Industry’s Continued Commitment to Quality

On July 22, the Ambulatory Surgery Center Quality Collaboration (ASCQC) held its sixth annual conference in Washington, DC. The meeting brought together a wide-ranging group of industry stakeholders, including representatives from facilities, physician groups, management companies, health information technology (IT) vendors, regulatory agencies, specialty societies, accreditation and quality organizations.


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HIPAA Biannual Update

Since ASCA’s last update at the beginning of the year, healthcare organizations across the country posted 216 breaches of protected health information (PHI) affecting 500 or more individuals.


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Congress Continues Work on Surprise Billing

In response to patient complaints about “surprise” bills after receiving services in an in-network facility, congressional activity has picked up on the issue over the last year.


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Elizabeth Munnich Discusses Her Research on ASCs

As part of ASCA's new Asked & Answered online series, Elizabeth Munnich, assistant professor of economics at the University of Louisville in Louisville, Kentucky, talks about her research into ASC quality.


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Protect Your ASC From Embezzlement

Scrubs. Gloves. Scalpels. Drapes. A rowboat. Which of these is not like the others?

Margaret Acker, RN, CASC, wishes she did not need to answer this question. She was the chief executive officer (CEO) of an ASC when she saw an unauthorized purchase of a rowboat on her ASC's credit card statement.


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Trump Administration’s Prescription Drug Plan Signals New Proposed Rules

The US now spends more per person on prescription medication than any other country, with more than $340 billion in total retail prescription drug spending per year. According to a October 2018 poll conducted by the Kaiser Family Foundation (KFF), healthcare was the most important issue area among registered voters, and healthcare costs, including prescription drugs, was listed as the most important issue within healthcare.


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ASCA 2019 at Full Blast

The ASCA 2019 Conference & Expo is in full swing in Nashville, Tennessee. The Gaylord Opryland Resort & Convention Center is abuzz with more than 2,200 attendees from 209 companies, 196 exhibitors and 26 sponsors.


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CMS Releases Draft Guidance on Hospital Co-Location with Other Healthcare Entities

On May 3, 2019, the Centers for Medicare & Medicaid Services (CMS) released draft hospital co-location interpretive guidance.


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Know Your Committees

A feature article in this month’s edition of ASC Focus highlights federal representatives that support the ASC community. With dozens of committees across the House and Senate, certain committees have jurisdiction over legislation directly relevant to your ASC and the patients you serve.


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ASCA Releases Procedure List Survey Results

At a February meeting, Centers for Medicare & Medicaid Services (CMS) officials asked ASCA representatives for codes that should be added to the ASC-payable list for 2020. In response, ASCA conducted a brief survey of its members, which wrapped up earlier this month.


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CMS, ONC Release New Regulations on EHI

On February 11, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) concurrently released two, long-awaited federal regulations addressing health information technology (HIT). The two rules seek to ease the flow of healthcare information, both from provider to patient as well as between providers, and add to a continually expanding regulatory framework governing electronic health information (EHI).


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Bohlke Joins HOP

Last week, the Hospital and Ambulatory Policy Group of the Centers for Medicare & Medicaid Services (CMS) invited Terry Bohlke, ex-president of the ASCA Board and vice president of Ambulatory Surgery Centers at Community Health Systems in Franklin, Tennessee, to serve on the Advisory Panel on Hospital Outpatient Payment (HOP).


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CMS Makes Changes to ASCQR Program

The Centers for Medicare & Medicaid Services (CMS) made significant changes to the ASC Quality Reporting (ASCQR) Program for 2019 and beyond, including the suspension of four outcomes measures that have been part of the ASCQR Program since its inception in 2012.


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HIPAA Biannual Update

Since ASCA’s last update in July, health care organizations across the country posted 163 breaches of protected health information (PHI) affecting 500 or more individuals. For the first time in two years a single type of breach, hacking or information technology (IT) incident, accounted for a majority (53 percent) of all breaches reported by the Office of Civil Rights (OCR).


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Going it Alone

Why would an ASC opt to stay independent instead of partnering with another health care organization? A partner might provide capital for facility expansions and new equipment or resources to assist with physician recruitment and managed care contract negotiations. Yet not all ASCs jump to take advantage of such potential opportunities.


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Pick the Right EHR

Over the past 10 years, electronic health record (EHR) adoption across all hospitals has increased from less than 10 percent to 96 percent, according to the Office of the National Coordinator for Health Information Technology. From information about the ASC industry that I have seen, I estimate that adoption in ASCs, however, has been low: less than 10 percent.


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Provisions in 2019 Updates to Medicare Physician Payments

ASCA regulatory coverage primarily focuses on Medicare payments to ASCs—called the technical component or technical payment—which are outlined and updated each year by a proposed rule in the summer and a final rule in the fall.


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ASCA CEO Discusses Medicare’s Final 2019 ASC Payment Rule

On November 2, 2018, the Centers for Medicare & Medicaid Services (CMS) released its final 2019 payment rule for ASCs and hospital outpatient departments (HOPD). ASCA Chief Executive Officer Bill Prentice talks about the policy changes the rule contains and the implications of those changes for ASCs.


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HHS Announces New Payment Model Proposal for Medicare Prescription Drugs

The US Department of Health & Human Services (HHS) unveiled a new payment model proposal that would drastically change the way Medicare pays for Part B prescription drugs. President Trump announced the proposed change during a speech at HHS on October 25. The proposal, broadly named the International Pricing Index (IPI) model, contains several reforms designed to reduce the prices Americans pay for prescription drugs.


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President Signs SUPPORT for Patients and Communities Act into Law

During a special signing event last week, President Donald Trump signed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6). The president’s signature on October 25 comes three weeks after the US Senate passed the legislation 98 to 1, and about a year after he first declared the opioid epidemic a national emergency.


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ASCA CEO Discusses Leapfrog Outpatient Reporting Program

The Leapfrog Group is a national nonprofit organization that has been collecting and reporting data about the quality and safety of inpatient hospital care for 20 years. Recently, Leapfrog announced plans to expand into the outpatient setting and begin collecting comparable data from ASCs and hospital outpatient departments (HOPDs).


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Congress Passes Long-Awaited Opioid Crisis Response Legislation

On October 3, Congress passed a final legislative agreement on the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (HR 6).


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Congress Passes Appropriations Bills as Fiscal Year Wraps up

For the first time in years, the US Congress passed several funding bills, known as appropriations, before the end of the fiscal year on September 30. Two respective appropriations measures fund programs that intersect with ASCs: private-sector care for veterans and Medicare.


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Two Congressional Hearings Feature ASCs

As part of the solution to health care challenges, the US House of Representatives and the US Senate featured ASCs in two hearings this month. Both hearings examined barriers to innovative health care and ways transparency can empower patients.


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Spotlight on Congressman John Larson

For 20 years, Congressman John Larson has represented Connecticut’s First District in the US House of Representatives. He is one of the strongest champions of the ASC community and has led ASC initiatives since 2011, including supporting the Ambulatory Surgical Center Quality and Access Act.


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Curbing the Opioid Epidemic

Emergency rooms (ER)—where a 2016 New York Times report says up to 75 percent of visits are for pain—can be a starting point for addiction. Many patients’ initial exposure to opioids, however, is immediately following outpatient surgery.


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ASCA CEO Discusses Proposed 2019 ASC Payment Rule

On July 25, the Centers for Medicare & Medicaid Services (CMS) released the 2019 proposed payment rule for ASCs and hospital outpatient departments (HOPD). ASCA Chief Executive Officer Bill Prentice talks about the policy changes proposed and the implications of those changes for ASCs.


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Apply Now to Take Your CAIP Exam

Electronic application is now open for the first exam period of the Certified Ambulatory Infection Preventionist (CAIP) credential scheduled for October 1–31, 2018. The CAIP credential is intended for licensed health care professionals interested in demonstrating their understanding of the skills and knowledge required to fill the role of an ASC infection preventionist.


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CMS Releases 2019 Proposed Medicare Payment Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2019 proposed payment rule for ASCs and hospital outpatient departments (HOPDs) on July 25. Of note, CMS has addressed a number of long-requested ASCA priorities, including proposing to align update factors, moving ASCs to the hospital market basket that is used to update HOPD payments. Under the proposal, CMS would use the hospital market basket to update ASC payments for the five-year period of calendar year (CY) 2019 through CY 2023.


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House Passes ASC Payment Transparency Act

The US House of Representatives passed the Ambulatory Surgical Center (ASC) Payment Transparency Act of 2018 (H.R. 6138) on July 24, 2018. This important legislation will improve access to high-quality outpatient health care.


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The Joint Commission Releases New Fluoroscopy Requirements

The Joint Commission will require ASCs to meet several new elements of performance (EP) primarily focused on fluoroscopy starting January 1, 2019. The new requirements will be applicable to accredited ASCs, office-based surgery (OBS) practices and hospital organizations that provide fluoroscopy services to their patients.


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HIPAA Biannual Update

The Office of Civil Rights (OCR), within the US Department of Health and Human Services (HHS), is the enforcement agency responsible for protecting rights related to health information privacy. This includes enforcement actions for violations of the Health Insurance Portability and Accountability Act (HIPAA), which delineates who can view or receive an individual’s protected health information (PHI) and sets standards for the security of PHI when being stored or transferred electronically.


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Advocating for Transparency in Health Care

Access to health care information has come under increased scrutiny in the US Congress, and momentum for better transparency is building. In February, a bipartisan group of senators requested information from health care stakeholders regarding cost of care and price transparency. Led by Senator Bill Cassidy, MD (R-LA), the group issued a letter to the health care community as the first step in an “effort to increase health care price and information transparency to empower patients, improve the quality of health care and lower health care costs.”


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House Committee Passes ASC Bill

On June 21, the US House of Representatives Committee on Ways and Means marked up the ASC Payment Transparency Act (H.R. 6138). This bill comprises half of the ASC Quality and Access Act (H.R. 1838).


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Congress Continues to Move Opioid Legislation

As summer approaches, our country’s top legislators are considering manifold measures to help improve opioid abuse. Just this week, the full US House of Representatives voted on dozens of bills, with dozens more on the docket for next week. On Tuesday, June 12, the US Senate Finance Committee voted 27-0 to send 22 unique measures, held collectively as the Helping to End Addiction and Lessen (HEAL) Substance Abuse Disorders Act, to the whole Senate.


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Study Examines Patient Outcomes Across Settings

A study published last December in the Journal of Health Economics looked at patient outcomes in ASCs versus hospital outpatient departments (HOPDs). The researchers found that patients undergoing procedures in an ASC were less likely to experience a subsequent inpatient hospital admission than those who underwent the same procedure in an HOPD.


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President Trump Signs VA Health Care Reform Bill

On June 6, President Donald Trump signed the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 to reform the US Department of Veterans Affairs (VA) health care system. The VA MISSION Act will directly impact ASCs that offer care to veterans, as one important provision requires non-VA provider claims be reimbursed in 30–45 days.


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Get Help, Not Headaches, from New Technology

As we prepare to head into the second half of 2018, the market forces helping to define ASC business decisions and operations this year are clear. Value-based care still sits atop health care organizations’ to-do lists, as does maintaining operational revenue amid shrinking payment margins. Patients continue to expect a high level of service, including easy access to appointments and compassionate communication from providers.


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ASC Quality Reporting Program Requirements for 2019

With the ASC Quality Reporting (ASCQR) Program web-based measure deadline of May 15, 2018, in the rearview mirror, it is time to look ahead to the data that will be reported for the Centers for Medicare & Medicaid Services (CMS) ASCQR Program in 2019 for 2020 payment determinations. It also is a good time to review some of the publicly available data on current measures to determine where ASCs can improve.


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Crossing the Atlantic to be at ASCA 2018

A delegation of 20 senior-level health care executives from eight Eurasian countries visited the Boston Eye Surgery & Laser Center in Boston, Massachusetts, as part of the US Department of Commerce’s Special American Business Internship Training (SABIT) Program during ASCA’s annual meeting in Boston, April 11-14.


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ASCA Endorses Veterans Deserve Better Act

ASCA endorses federal legislation that, if passed, would support ASCs as they serve combat veterans. The Veterans Deserve Better Act (H.R. 4783 / S. 2239), introduced by Jacky Rosen (D-NV) in the US House of Representatives and Debbie Stabenow (D-MI) in the US Senate, addresses claims reimbursement for care providers outside of the US Department of Veterans Affairs (VA). The measure would require non-VA provider claims to be reimbursed in 30-45 days. Bill Prentice, ASCA’s chief executive officer, issued an endorsement letter to both legislators.


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Oregon passes HB 4020 on Extended Stay Centers

After five years of development and discussions, the Oregon Legislative Assembly passed House Bill 4020 unanimously. This bill creates a license for extended stay recovery centers, where patients can have 48 hours to recover from the time of admission at the ASC, as compared to the 24-hour limitation for ASCs, says Chris D. Skagen, chief executive officer of Strategic Resources Group (SRG) in Denver, Colorado.


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Boston Calling

Where can you find thousands of your peers, ASC industry leaders, cutting-edge technology, the Green Monster, chowder and duck tours all in one place? Boston, Massachusetts, of course, between April 11 and 14, when ASCA 2018 convenes at the Hynes Convention Center. Need some more reasons why you need to be at this meeting? Read on.


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HIPAA Biannual Update

Since our last update in September, health care organizations across the country posted 180 breaches of protected health information (PHI) affecting 500 or more individuals.


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Study Proves ASCs Can Provide Value-Based Orthopedic Surgery

An ASC chain partnered with ValidCare for a multi-year, multi-phase pilot that began in 2016 to determine whether specific orthopedic and spine procedures, which had historically been in-patient procedures, could be performed at its ASCs at a lower cost while maintaining or improving the quality of outcome and patient satisfaction.


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Who Can and Cannot Translate in ASCs?

In 2010, the Patient Protection and Affordable Care Act—commonly referred to as the ACA—brought sweeping regulatory changes to the health care industry. Section 1557 of the ACA instituted new nondiscrimination requirements, which prohibits health care providers from discriminating in health care or health coverage based on a variety of traits.


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Improve Your ASC's Safety Culture

In 2014, the Andrews Institute Ambulatory Surgery Center in Gulf Breeze, Florida, conducted its first annual safety culture survey. It asked the employees to rank the ASC's performance in areas including safety priority within the facility, safety as part of the ASC's ongoing agenda, accountability, issues corrected, teamwork and training.


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Provide Health Literacy to Patients

ASC staff typically have limited time to spend with patients. This makes it imperative for staff to take advantage of every moment available to provide critical education to patients, says Missy Soliz, RN, quality and risk manager for Mississippi Valley Surgery Center and Mississippi Valley Endoscopy Center in Davenport, Iowa. "We must also do so without overwhelming them or talking over their heads," she says.


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The Joint Commission Updates Emergency Management Requirements

In response to the Centers for Medicare & Medicaid Services (CMS) emergency preparedness final rule, The Joint Commission is updating its emergency management requirements for ASCs and other types of accredited organizations.


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AJRR Issues 2017 Annual Report

The American Joint Replacement Registry (AJRR) has issued its 2017 Annual Report on hip and knee arthroplasty data. The report analyzes data on 860,080 hip and knee replacement procedures performed by 4,755 surgeons at 654 organizations.


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Options for Post-Acute Services

As more complex procedures continue to move to the outpatient setting, ASCs should actively be looking at where patients can receive the best post-acute recovery care, recommends Rebecca Craig, RN, CASC, ASCA Board president and chief executive officer of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colorado.


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Lending a Healing Hand

One World Surgery in Chicago, Illinois, a nonprofit, partners with communities, health-care providers and leaders in health care to deliver surgical services globally. ASCA has joined hands with the organization to help fulfill its mission. Below is an excerpt from an interview with Claire Cunningham, executive director of the organization.


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Battling the Hurricane-Driven Drug Shortages

Hurricane Maria devastated Puerto Rico last month and disrupted the production of several drugs and medical supplies, including IV solutions. While the US Food and Drug Administration (FDA) is working with companies, such as Baxter International, to alleviate the shortages, ASCs could take a few steps to manage the shortages effectively.


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ASC Study Finds Colonoscopy Patients Prefer Propofol

Results of a clinical trial conducted at an Ohio ASC show that patients prefer propofol over a combination of fentanyl/midazolam as their anesthetic for outpatient colonoscopies. From a patient and provider perspective, the researchers conclude, propofol appears to be superior to fentanyl/midazolam for outpatient colonoscopy.


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HIPAA Biannual Update

Since our last update in January, health care organizations across the country posted 145 breaches of protected health information (PHI) affecting 500 or more individuals. Most of the breaches (77 percent) were caused by unauthorized access and hacking.

OCR Breach Investigation Causes


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OSHA Updates its Regulations

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).


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MACRA Is Here

In last year’s November-December Focus magazine we outlined the Medicare Access and CHIP Reauthorization Act, commonly known as MACRA. This act, passed in 2015, instituted new mechanisms for Medicare physician payment, replacing the old Sustainable Growth Rate (SGR) formula. With the arrival of a new administration, as well as the June release of proposed updates, it seems worthwhile to reiterate MACRA’s overarching structure, highlight some new developments and give an indication of how it might affect clinicians operating in ASCs in the coming years.


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Got OAS CAHPS Questions?

While most in the ASC community are now aware that the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey will be mandated by the Centers for Medicare & Medicaid Services (CMS), a lot of questions remain.


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Know Your State’s Nursing Scope of Practice Definitions

The term “scope of practice” has different definitions in policy and professional documents, which is why it is critical to know how your state’s regulations define the term, says Debra Stinchcomb, RN, CASC, consultant with Progressive Surgical Solutions in Fayetteville, Arkansas.


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ASCA 2017 Convenes in Washington, DC, this Month

At a time when Washington, DC, is under the world’s microscope, it seems fitting that ASCA is bringing the ASC community into the heart of the action at ASCA 2017, May 3–6, at the Gaylord National Resort & Convention Center in National Harbor, Maryland.


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Attend the Federal Policy Sessions at ASCA 2017

ASCA’s annual meeting this year, ASCA 2017, will take place May 3–6 at the Gaylord National Resort & Convention Center in Washington, DC. There is no better time or place to learn more about the ways that the decisions the federal government is making will impact your ASC.


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21st Century Cures Act Becomes Law

Late last year, Congress passed the 21st Century Cures Act, which includes a version of the Electronic Health Fairness Act of 2015. The bipartisan Cures Act, introduced by US Representatives Fred Upton (R-MI) and Dianne DeGette (D-CO) and signed into law by President Barack Obama on December 13, 2016, is a large, nearly 1,000-page legislative package that provides funding for the National Institutes of Health, the Food and Drug Administration, combating opioid abuse and more.


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HIPAA Biannual Update

Since our last update in April 2016, health care organizations across the country posted 257 breaches of protected health information (PHI) affecting 500 or more individuals. The majority of the breaches included unauthorized access and hacking.


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Introducing the New ASCA Affiliate Program

New this year, the Ambulatory Surgery Center Association (ASCA) has introduced an Affiliate Program that replaces the ASCA Vendor Membership category. The new five-tiered recognition program was developed to recognize and further support the ASC industry’s suppliers and business partners dedicated to helping you run your centers more effectively and efficiently. Members of the Affiliate Program can be identified by the ‘Affiliate’ button within their advertisements throughout ASCA and industry publications and web sites, as well as onsite at conferences and seminars.


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Achieving and Sustaining a Culture of Patient-Centric Care

The culture that an ASC is aiming for doesn’t just develop naturally, says Jo Ellen Braden, RN, CASC, quality assurance performance improvement (QAPI) coordinator at Taylor Station Surgical Center in Columbus, Ohio. It requires hard work and commitment.


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Outcomes of Spine Surgery in an ASC

The number of anterior cervical discectomy and fusion (ACDF) surgeries, one of the most common spine procedures performed in the US today, continues to rise as a result of the growing elderly population in the country, says Anthony L. Asher, MD, ASCA Board member, director of the Neuroscience Institute at Carolinas HealthCare System and a senior partner at Carolina Neurosurgery & Spine Associates in Charlotte, North Carolina.


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Bundle Up

The federal government has initiated broad adoption of bundled payment methodologies in inpatient settings including the Bundled Payment for Care Improvement (BPCI) initiative and more recently, the Comprehensive Care for Joint Replacement (CJR) regulations. According to the Centers for Medicare & Medicaid Services (CMS) more than 500 hospitals now participate in these programs.


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Top 2015 CMS Citations

The Centers for Medicare & Medicaid Services (CMS) ran a FY 2015 citation frequency report for ASCA for both health surveys and Life Safety Code surveys. Unfortunately, we do not have more specific information as to what areas within each tag might be commonly cited, but this should at least give facilities an idea of where CMS is focusing its attention.

Infection control issues were once again at the top of the “Most Cited” listed. We expect this to continue to be a hot survey topic, since CMS updated the Infection Control Surveyor Worksheet last summer.


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Grow Your ASC

It is no secret that growing an ASC can be a challenge. Every ASC administrator is faced with the same goals: optimizing capacity and continuously growing the center’s volume. The multispecialty center—four operating rooms and two procedure rooms—that I manage was no exception. In 2010, the center was barely performing 100 cases each month, and we were competing in a very tight market. Within a five-mile radius of our center, there were no fewer than 17 single-specialty surgery centers.


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Phase Two of HIPAA Audit Program Underway; Are you Ready?

As a part of its continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates. OCR will review the policies and procedures adopted and employed by covered entities and their business associates. These audits will primarily be desk audits, although some on-site audits will be conducted.


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Banner Health, Phoenix VA Partner to Deliver Care to Veterans

Banner Health of Phoenix, Arizona, will join hands with Phoenix VA Health Care System on a public-private partnership that will help expedite outpatient surgical care to thousands of veterans in the Phoenix area, according to a May 12, 2016, release.

Officials at the partnering organizations expect Phoenix VA physicians to provide approximately 2,500 surgeries per year at Banner Health’s SurgiCenter in Phoenix, Arizona, over the span of the five-year agreement.


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CMS Approves New ASC Accrediting Agency

The Centers for Medicare & Medicaid Services (CMS) approved the Institute for Medical Quality (IMQ) of San Francisco, California, as a national accrediting organization for ASCs that participate in the Medicare or Medicaid programs (also known as Medicare deemed status). The approval came on April 29, 2016, following a CMS review conducted to ensure that IMQ’s standards of accreditation meet or exceed Medicare’s Conditions for Coverage requirements.


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ASCA 2016 Convenes in Dallas in May

Plan now to make the most of the opportunities there

In a year filled with change and uncertainty in health care, ASCA is offering ASC professionals a one-stop shop where they can get everything they need to manage their facility more effectively and make critical decisions that will ensure their ASC’s future success. ASCA 2016, May 19–22 at the Gaylord Texan Resort & Convention Center in Dallas, Texas, is that destination.


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HIPAA Quarterly Update

First quarter 2016: January 1–March 31

The Secretary of the US Department of Health and Human Services (HHS) requires health care organizations to publicly post breaches of health information protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that affect 500 or more individuals. During the first quarter of 2016, health care organizations across the country posted 54 breaches of protected health information (PHI) affecting 500 or more individuals. When compared to the first quarter of 2015, the number and types of breaches are similar and do not indicate significant changes or trends. Unauthorized uses/disclosures of a patient’s PHI was the most frequent type of breach during the first quarter, and historically is the most frequent type of breach.


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Manage Your Drug Supply

Effective ways to keep on top of shortages and costs

Managing her ASC's medication inventory is not just an occasional part of the job for Cheryl Ezerskis, CASC, executive director at West Parkway Ambulatory Surgery Center in Pompton Plains, New Jersey. "I spend more time managing our inventory than I care to admit," she says. "I have to monitor medications every day. Getting the medications we need to do our procedures is a never-ending game I have to play."


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Accreditation Agency Opens Advanced Certification Program

The first of its kind for ASCs

The Joint Commission launched its Total Hip and Knee Replacement Advanced Certification Program and began to accept applications from interested facilities on December 17, 2015. On-site reviews will start on March 14, says Wendi Roberts, executive director of certification at The Joint Commission. “We are getting applications every day and currently have approximately 15 applications [as of Feb. 3, 2016],” she says.


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New and Improved

More spine and gynecologic procedures move to the outpatient setting

Substantial developments in outpatient spine surgery in recent years make many spine procedures a much better match to the outpatient setting than before, and this trend is likely to continue, says Fred Naraghi, MD, an orthopedic surgeon and neurosurgeon who practices out of the Comprehensive Spine Center and performs cases at San Francisco Surgery Center, both located in San Francisco, California.


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