Message from the President

Let’s Talk Safety

It is that time of year when the cold weather starts to ease a bit and we find ourselves outdoors and looking forward to summer. One thing to consider at this time is how to maintain the safety of family and friends while participating in our favorite outdoor activities. It also is a great time to review and update the patient safety protocols and procedures at our facilities.

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Message from the CEO

News from ASCA

Summer is on us. While this is the time when many of us go on vacation, I want to take a moment to tell you about what ASCA is doing for you and your ASC.

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As I See It

Streamline and Implement COVID-19 Vaccination Tracking Requirements

Advice for achieving and maintaining compliance

The Centers for Medicare & Medicaid Services (CMS) recently released updated guidance on how to comply with COVID-19 Vaccination Requirements for Health Care Providers and Suppliers. This new Conditions for Coverage (CfC) requirement can be found under 42 CFR §416.51(c) Conditions for coverage - Infection control; Standard: COVID-19 vaccination of staff.

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Doing Business

Engage Physicians Effectively

Necessary tips for success

Successful ASCs rely on strong and efficient partnerships with physicians. As ASCs continue to expand and strengthen their role in the healthcare delivery system, it is critical that the industry continues to evolve by finding more effective and efficient ways to engage physicians.

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ASCA 2022

Who Signs on the Dotted Line?

Come to ASCA 2022 to learn how to avoid legal risks during the informed consent process

When we are out doing surveys, we see that people do not have a clear understanding of the informed consent process. The process is more than just a form that needs to be signed before a procedure. It involves multiple steps.

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History and Role of MedPAC

Where do ASCs fit in

On two mornings every month between September and January, a long line of people waits to enter a wood-paneled meeting room in the Ronald Reagan Building in downtown Washington, DC. Whether they are lobbyists, regulatory consultants or patient advocates, the people in line all have a special interest in health policy.

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Host Facility Tours

Educate your lawmakers and advocate for ASCs

In 2019, ASCA members hosted facility tours for state and federal lawmakers representing diverse constituencies across the country. These tours helped shore up support for ASCs among longstanding legislators and introduced new state and federal officials to the ASC setting.

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Procedure Shift to ASCs Continues

How existing health systems are responding

ASCs are proliferating nationwide. At the ground level, however, markets vary substantially in their pace of procedural shift into ASCs, leaving legacy health systems’ share and revenue vulnerable to varying degrees.

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Total Joint Replacements Move Outpatient Faster than Anticipated

Four considerations for ASCs preparing to harness the trend

Total joint replacement (TJR) surgeries have been steadily migrating from inpatient to outpatient settings in recent years, and that trend is building momentum even faster than previously anticipated. We believe that at least 70 percent of TJR surgery volume, perhaps more, can now be outpatient.

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Nap Gary’s Legacy Continues Through ASCA Lifetime Award

Who can nominate and how

The ASCA Board of Directors established the Nap Gary Legacy Award for Lifetime Achievement in the ASC Community to recognize individuals whose contributions have made a difference in the ASC industry.

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In Memoriam

ASC community remembers a beloved leader

Randy Leffler, 51, executive director of the Ohio Association of Ambulatory Surgery Centers (OAASC), passed away last December.

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Q & A

Bundling Care

An ASC director of operations discusses value-based payments in her surgery center

Becky Ziegler-Otis, CASC, ASCA Board member and director of operations for revenue cycle at Ambulatory Surgical Center of Stevens Point in Stevens Point, Wisconsin, recently talked with ASC Focus about how the center’s prior experience with bundled payments helped prepare it to participate in WC Bundled Payments, Trilogy Health Solutions’ workers’ compensation cost-containment program.

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Hurdles Slowing Down Migration of Procedures

Barriers to moving complex procedures from HOPDs to your ASC

CY 2021 brought policy and reimbursement changes that would seem to position ASCs favorably for an obvious migration of cases from the hospital outpatient department (HOPD) to the ASC.

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Improve Claim Compliance

Use correct modifiers

In the coding world, modifiers are two-digit symbols added to CPT procedure codes to signify the procedure has been altered in some way.

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Eliminate Common ASC Coding and Billing Compliance Issues

Follow these steps

Noncompliant coding and billing can lead to increased denials, missed reimbursement opportunities and unnecessary refunds. Additionally, poor compliance outcomes harm surgeon and patient satisfaction and could lead to more serious consequences, including loss of payer contracts and legal ramifications.

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HIPAA Biannual Update

July to December 2018

Since ASCA’s last update in July 2018, healthcare organizations across the country posted 163 breaches of protected health information (PHI) affecting 500 or more individuals.

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Legal Matters

Informed Consent Process in Ambulatory Surgery

Review state laws and AHRQ materials before creating your policy

In rare situations, the duration of the informed consent could present an issue. Some state laws presume that a written authorization signed by the patient is valid. Some states might specify the time frame in which consent remains valid; others require that consent be obtained no more than 30 days from the procedure. Therefore, checking state regulations is essential.

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Build a Data-Driven Marketing Program

Foster relationships by eliminating the guesswork

Relying on word-of-mouth to cultivate awareness is not enough to establish and build reputation among potential patients in today’s competitive healthcare marketplace. Patients are using various means to shop for and select their care providers, and it is helpful to have a marketing program that connects with people as they consider options.

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Trends in Medical Risk Transfer

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

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

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ASCA Advocates for Fair Implementation of Section 603

Congress passes site-neutral payment legislation

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

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Quality Improvement

Stay on the Forefront of Efficiency and Quality

Consider these new strategies

During the last 27 years, as an ophthalmic surgeon, I also was part owner of an ASC in Washington, DC. While I was able to transition successfully, I wish I had had many of the tools and features available today that would have made my life easier and my business more profitable.

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Air-Cleaning Options for Facility Hygiene

Purification systems and UV-C technology help reduce the spread of infectious particles

Now that we know that COVID-19 can be airborne during medical procedures that generate aerosols, implementing technologies and best practices that limit the potential exposure of pathogens in aerosols has become essential.

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Infection Prevention

Build an Effective Infection Prevention Program

Rely on sound policies, careful training and accountability

ASC employees often wear multiple hats and fill multiple roles that are normally individualized at larger facilities. In some cases, surgery centers have tight reprocessing areas or limited equipment, tools or chemistries to reprocess devices. Having access to the most updated instructions for use (IFU) is critical for success in this field and these situations.

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Preparing for and Responding to a Data Breach

Have a written plan, implement it in a timely manner and communicate with your patients

ASCs are attractive targets for cybercriminals. Surgery centers collect and store vast amounts of sensitive personal information. This is highly valued as it can be used for identity theft, blackmail and extortion.

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Review Key Revenue Cycle Metrics as Your ASC Grows

Consider improving processes in these four areas as your center adds more complex procedures to its list

Driven by continuous successful outcomes in the outpatient setting, ASCs have emphasized incorporating more complex procedures into their repertoires as a formative growth strategy.

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Is Your Billing Team Performing Optimally?

Take a deep dive into your processes to decide

Your ASC is well-positioned in the community. It has a good reputation, as do your providers. Your caseload is steady or perhaps growing. You have a happy, busy staff.

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Regulatory Review

States Move Slowly to Align with CMS Changes

Since 2019, two states have modified their transfer agreement and H&P requirement laws, but admitting privilege requirements remain in place

Only two states, Alaska and Delaware, have adapted their state laws to match the changes to transfer agreement and history and physical examination (H&P) requirements 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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Advocacy Spotlight

ASCs Will Grow in Number, Volume

TASCS head discusses the importance of advocacy in the progress of surgery centers

Krista DuRapau, executive director of the Texas Ambulatory Surgical Center Society, sees membership as the main drive for successful advocacy work.

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Member Profile

Cristina Bentin

Cristina Bentin, president of Coding Compliance Management LLC in Franklin, North Carolina, discusses how actions of the business office staff impact patient satisfaction.

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Industry Insight

William A. Miller

William A. Miller, partner at Higgs, Fletcher, & Mack LLP in San Diego, California, discusses the most important legal issues for ASCs this year.

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Attend ASCA’s June and July Webinars

ASCA will offer three webinars in June and July, all from the Business Office Personnel track.

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Web Crawl

Mark Your Calendar for National ASC Month

This August, surgery centers around the country will host facility tours for elected officials, the media and members of their community to promote awareness of ASCs and celebrate National ASC Month.

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