HHS: ASC list will include all procedures except for those with risks, overnight stays
HHS: ASC list will include all procedures except for those with risks, overnight stays
Michael O. Leavitt, secretary of the Department of Health and Human Services (HHS), has announced that HHS will propose including all outpatient surgical procedures on the list of approved procedures for ambulatory surgery centers (ASCs), except for those that department officials think would pose a significant safety risk in a center and those that would require an overnight stay.
"The letter is extremely significant as it is the first time that a senior HHS official has indicated support for the MedPAC [Medicare Payment Advisory Commission] recommendation to significantly expand the list, saving the program and its beneficiaries money," says Kathy Bryant, executive vice president of the Federated Ambulatory Surgery Association (FASA). "The letter from Secretary Leavitt indicates that CMS [the Centers for Medicare & Medicaid Services] is finally going to try to expand fully Medicare beneficiaries access to ASCs."
The change would come as part of the implementation of a new ASC payment system in 2008. Also, Leavitt announced that HHS will update the current ASC procedures list by July 1, 2007. The announcements came in a letter from Leavitt to Sen. Mike Crapo (R-ID), a sponsor of The Ambulatory Surgical Center Payment Modernization Act. That act would expand Medicare coverage for ASC services and revamp the ASC payment system. It would set the ASC reimbursement rate at 75% of the hospital outpatient department (HOPD) rate. Generally, ASCs would be paid in the same manner and for the same things as HOPDs, except ASCs would not be paid for outliers, graduate medical education, or capital.
Although the Leavitt letter indicates that the ASC list will be expanded significantly, it is not clear that it will go as far as the MedPAC recommendation, Bryant says. "For example, it does not indicate that CMS will use a list of what is not paid for in an ASC rather than what is," she says.
This process change is beneficial, Bryant points out. In addition the legislation also includes specifics on payment reform, she says. "Thus, FASA still believes the legislation is critical."
Leavitt is on target with his policy recommendation to expand beneficiary access to services within ASCs, says Craig Jeffries, Esq., executive director of the American Association of Ambulatory Surgery Centers (AAASC). "This recommendation is consistent with an earlier MedPAC recommendation to eliminate the ASC procedure list and reinforces a goal of Sen. Crapo’s legislation — The Ambulatory Surgical Center Payment Modernization Act — to empower patients and their physicians to exercise a wider choice on where to have surgery," Jeffries says.
The big question is what will the department find to be a significant risk or require an overnight stay, says Don May, vice president for policy for the American Hospital Association in Washington, DC. "It’s unclear what the final ASC list will look at until we see proposals from CMS," he says. "It’s just as likely more could be taken off the list than added, but it’s hard to tell."
Michael O. Leavitt, secretary of the Department of Health and Human Services (HHS), has announced that HHS will propose including all outpatient surgical procedures on the list of approved procedures for ambulatory surgery centers (ASCs), except for those that department officials think would pose a significant safety risk in a center and those that would require an overnight stay.Subscribe Now for Access
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