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Lawmakers Introduce Bill to Overhaul ASC Reimbursement

Proposed legislation would put ASC payment updates and incentives on more equal footing with HOPDs.

Published: June 3, 2011

A bipartisan bill introduced in Congress today would enact 2 major changes in ambulatory surgery center reimbursement that the ASC industry has long been clamoring for: Medicare payment updates tied to the hospital market basket and a value-based purchasing program that would generate shared savings for CMS and high-performing ASCs.

The Ambulatory Surgical Center Quality and Access Act of 2011, introduced by Reps. Pete Sessions (R-Texas), John Larson (D-Conn.), Shelley Berkley (D-Nev.) and Bill Cassidy (R-La.), attempts to preserve "patient access to the high quality, cost-effective health care services that" ASCs provide, says the Ambulatory Surgery Center Association in a news release.

The proposal to tie ASC Medicare payment updates to the hospital market basket instead of the Consumer Price Index for all Urban Consumers (CPI-U), already has the support of more than 20 senators who expressed their concern with the current system in a letter to CMS late last year. And in April, the Department of Health and Human Services proposed a value-based purchasing system (VBP) for ASCs but warned that it lacked legislative authority to implement it. The bill introduced today would compel HHS to implement VBP for ASCs by Jan. 1, 2015.

Another section of the bill addresses the same-day notification rule for ASCs by allowing patients "who wish to receive care sooner" to let their ASC physician "provide disclosure notifications on the same day that their procedure is to be performed" — the same notification standards that are applied to hospital-based outpatient departments.

ASCA is encouraging ASC leaders and advocates to send letters to their representatives in Congress urging them to support the legislation. Read the full bill here.

Irene Tsikitas

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