Digital Debut
APRIL 19, 2024
After three days of roaring success, 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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APRIL 12, 2024
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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MARCH 29, 2024
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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MARCH 22, 2024
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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MARCH 15, 2024
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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MARCH 7, 2024
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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MARCH 1, 2024
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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FEBRUARY 23, 2024
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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FEBRUARY 16, 2024
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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FEBRUARY 8, 2024
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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JANUARY 26, 2024
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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JANUARY 19, 2024
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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JANUARY 11, 2024
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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DECEMBER 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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DECEMBER 2023
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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DECEMBER 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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DECEMBER 2023
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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NOVEMBER 2023
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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NOVEMBER 2023
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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OCTOBER 2023
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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OCTOBER 2023
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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SEPTEMBER 2023
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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SEPTEMBER 2023
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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SEPTEMBER 2023
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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SEPTEMBER 2023
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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AUGUST 2023
Earlier this month, South Kansas City Surgicenter in Overland Park, Kansas, hosted a tour for Representative Sharice Davids (D-KS).
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AUGUST 2023
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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AUGUST 2023
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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JULY 2023
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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JULY 2023
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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JULY 2023
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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JULY 2023
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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JUNE 2023
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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JUNE 2023
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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JUNE 2023
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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JUNE 2023
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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MAY 2023
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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MAY 2023
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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MAY 2023
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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MAY 2023
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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APRIL 2023
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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APRIL 2023
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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MARCH 2023
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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MARCH 2023
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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MARCH 2023
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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MARCH 2023
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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FEBRUARY 2023
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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FEBRUARY 2023
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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FEBRUARY 2023
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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JANUARY 2023
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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JANUARY 2023
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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JANUARY 2023
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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DECEMBER 2022
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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DECEMBER 2022
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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DECEMBER 2022
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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DECEMBER 2022
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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NOVEMBER 2022
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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NOVEMBER 2022
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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NOVEMBER 2022
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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OCTOBER 2022
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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OCTOBER 2022
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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OCTOBER 2022
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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SEPTEMBER 2022
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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SEPTEMBER 2022
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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SEPTEMBER 2022
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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SEPTEMBER 2022
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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AUGUST 2022
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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AUGUST 2022
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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AUGUST 2022
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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JULY 2022
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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JULY 2022
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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JULY 2022
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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JULY 2022
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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JULY 2022
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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JUNE 2022
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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JUNE 2022
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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JUNE 2022
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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MAY 2022
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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MAY 2022
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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MAY 2022
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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BY SAHELY MUKERJI | APRIL 2022
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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BY ALEX TAIRA | APRIL 2022
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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BY KARA NEWBURY | MARCH 2022
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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BY ALEX TAIRA | MARCH 2022
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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BY ALEX TAIRA | MARCH 2022
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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BY STEPHEN ABRESCH | FEBRUARY 2022
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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BY KARA NEWBURY | FEBRUARY 2022
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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BY STEPHEN ABRESCH | FEBRUARY 2022
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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BY MAIA KUNKEL | JANUARY 2022
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.
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BY STEPHEN ABRESCH | JANUARY 2022
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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BY ALEX TAIRA | JANUARY 2022
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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BY KARA NEWBURY | DECEMBER 2021
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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BY STEPHEN ABRESCH | DECEMBER 2021
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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BY KARA NEWBURY | DECEMBER 2021
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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BY KARA NEWBURY | NOVEMBER 2021
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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INTERVIEWED BY SAHELY MUKERJI | NOVEMBER 2021
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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BY ALEX TAIRA | OCTOBER 2021
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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BY STEPHEN ABRESCH | OCTOBER 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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BY STEPHEN ABRESCH | OCTOBER 2021
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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BY KARA NEWBURY | OCTOBER 2021
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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BY KARA NEWBURY | SEPTEMBER 2021
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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BY ALEX TAIRA | SEPTEMBER 2021
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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BY SAHELY MUKERJI | SEPTEMBER 2021
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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BY STEPHEN ABRESCH | AUGUST 2021
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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BY KAY TUCKER | AUGUST 2021
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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BY ALEX TAIRA | AUGUST 2021
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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BY KARA NEWBURY | JULY 2021
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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BY MAIA KUNKEL |JULY 2021
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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BY KARA NEWBURY | JULY 2021
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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BY STEPHEN ABRESCH | JUNE 2021
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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BY KARA NEWBURY | JUNE 2021
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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BY KARA NEWBURY | JUNE 2021
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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BY SAHELY MUKERJI | JUNE 2021
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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BY ALEX TAIRA | JUNE 2021
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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MAY 2021
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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BY ADAM PARKER | MAY 2021
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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BY STEPHEN ABRESCH | MAY 2021
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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BY KARA NEWBURY AND GINA THRONEBERRY | APRIL 2021
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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BY KARA NEWBURY AND GINA THRONEBERRY | APRIL 2021
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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BY STEVE SELDE | APRIL 2021
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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BY KARA NEWBURY AND STEVE SELDE | APRIL 2021
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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BY ALEX TAIRA | MARCH 2021
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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BY ADAM PARKER | MARCH 2021
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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BY KARA NEWBURY | MARCH 2021
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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BY STEPHEN ABRESCH | FEBRUARY 2021
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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INTERVIEWED BY SAHELY MUKERJI | FEBRUARY 2021
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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BY STEVE SELDE | FEBRUARY 2021
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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BY SAHELY MUKERJI | JANUARY 2021
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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BY MAIA KUNKEL | JANUARY 2021
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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BY STEVE SELDE | JANUARY 2021
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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BY SAHELY MUKERJI | DECEMBER 2020
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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BY KARA NEWBURY | DECEMBER 2020
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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BY SAHELY MUKERJI | DECEMBER 2020
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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BY KARA NEWBURY | DECEMBER 2020
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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BY SAHELY MUKERJI | NOVEMBER 2020
Ann Shimek, RN, CASC, senior vice president and chief clinical officer at Surgery Partners, passed away on November 25.
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BY ADAM PARKER | NOVEMBER 2020
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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BY ROBERT KURTZ | NOVEMBER 2020
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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BY SAHELY MUKERJI | OCTOBER 2020
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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BY KARA NEWBURY | OCTOBER 2020
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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BY ADAM PARKER | OCTOBER 2020
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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SEPTEMBER 2020
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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BY STEPHEN ABRESCH | SEPTEMBER 2020
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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BY STEVE SELDE | SEPTEMBER 2020
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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BY KARA NEWBURY | AUGUST 2020
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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BY SAHELY MUKERJI | AUGUST 2020
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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BY KARA NEWBURY | AUGUST 2020
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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BY MAIA KUNKEL | JULY 2020
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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BY STEVE SELDE | JULY 2020
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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BY SAHELY MUKERJI | JULY 2020
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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BY SAHELY MUKERJI | JULY 2020
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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BY STEVEN SELDE | JULY 2020
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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BY SAHELY MUKERJI | JUNE 2020
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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BY MAIA KUNKEL | JUNE 2020
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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BY ALEX TAIRA | JUNE 2020
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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BY STEVE SELDE | MAY 2020
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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BY SAHELY MUKERJI | MAY 2020
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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BY SAHELY MUKERJI | MAY 2020
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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BY SAHELY MUKERJI | APRIL 2020
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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APRIL 2020
The Centers for Medicare & Medicaid Services (CMS) released guidance April 19 on restarting non-emergent non-COVID-19 healthcare.
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BY SAHELY MUKERJI | APRIL 2020
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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APRIL 2020
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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BY STEVEN SELDE | MARCH 2020
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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BY SAHELY MUKERJI | MARCH 2020
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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MARCH 2020
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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BY STEVEN SELDE | MARCH 2020
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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BY STEPHEN ABRESCH | FEBRUARY 2020
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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BY ADAM PARKER | FEBRUARY 2020
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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BY STEPHEN ABRESCH | FEBRUARY 2020
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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JANUARY 2020
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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BY SAHELY MUKERJI | JANUARY 2020
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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BY ALEX TAIRA | JANUARY 2020
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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BY STEPHEN ABRESCH | JANUARY 2020
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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BY ALEX TAIRA | DECEMBER 2019
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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BY STEVE SELDE | NOVEMBER 2019
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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BY KARA NEWBURY | NOVEMBER 2019
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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BY KARA NEWBURY | NOVEMBER 2019
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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OCTOBER 2019
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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BY SAHELY MUKERJI | OCTOBER 2019
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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BY ALEX TAIRA | OCTOBER 2019
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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BY ADAM PARKER | OCTOBER 2019
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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BY KARA NEWBURY | SEPTEMBER 2019
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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BY KARA NEWBURY | SEPTEMBER 2019
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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BY ADAM PARKER | SEPTEMBER 2019
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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BY KARA NEWBURY | AUGUST 2019
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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AUGUST 2019
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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BY STEPHANIE ELLIS, RN | AUGUST 2019
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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BY ALEX TAIRA | JULY 2019
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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BY ALEX TAIRA | JULY 2019
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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BY STEVE SELDE | JUNE 2019
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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JUNE 2019
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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BY ROBERT KURTZ | JUNE 2019
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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BY ALEX TAIRA | MAY 2019
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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BY SAHELY MUKERJI | MAY 2019
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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BY KARA NEWBURY | MAY 2019
On May 3, 2019, the Centers for Medicare & Medicaid Services (CMS) released draft hospital co-location interpretive guidance.
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BY STEVE SELDE | APRIL 2019
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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BY KARA NEWBURY | MARCH 2019
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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BY ALEX TAIRA | MARCH 2019
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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BY SAHELY MUKERJI | MARCH 2019
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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BY KARA NEWBURY | JANUARY 2019
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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BY ALEX TAIRA | JANUARY 2019
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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BY ROBERT KURTZ | JANUARY 2019
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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BY TOM SCOTT | DECEMBER 2018
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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BY ALEX TAIRA | DECEMBER 2018
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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NOVEMBER 2018
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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BY ALEX TAIRA | NOVEMBER 2018
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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BY JEFF EVANS | NOVEMBER 2018
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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OCTOBER 2018
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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BY JEFF EVANS | OCTOBER 2018
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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BY JEFF EVANS | OCTOBER 2018
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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BY JEFF EVANS | SEPTEMBER 2018
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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BY JEFF EVANS | SEPTEMBER 2018
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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BY MAURA DENT CASH, RN, CASC | AUGUST 2018
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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AUGUST 2018
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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JULY 2018
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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BY KARA NEWBURY | JULY 2018
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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BY JEFF EVANS | JULY 2018
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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BY SAHELY MUKERJI | JULY 2018
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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BY ALEX TAIRA | JULY 2018
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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BY JEFF EVANS | JULY 2018
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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BY JEFF EVANS | JUNE 2018
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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BY JEFF EVANS | JUNE 2018
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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BY SAHELY MUKERJI | JUNE 2018
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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BY JEFF EVANS | JUNE 2018
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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BY DAN MONTZKA, MD, AND TERA ROY | MAY 2018
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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BY KARA NEWBURY | APRIL 2018
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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BY SAHELY MUKERJI | APRIL 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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BY JEFF EVANS | APRIL 2018
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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BY SAHELY MUKERJI | MARCH 2018
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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BY ROBERT KURTZ | FEBRUARY 2018
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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BY ALEX TAIRA | JANUARY 2018
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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JANUARY 2018
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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BY ALEX TAIRA | DECEMBER 2017
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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BY ROBERT KURTZ | DECEMBER 2017
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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BY ROBERT KURTZ | NOVEMBER 2017
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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BY ROBERT KURTZ | NOVEMBER 2017
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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BY ROBERT KURTZ | NOVEMBER 2017
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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BY SAHELY MUKERJI | NOVEMBER 2017
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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INTERVIEWED BY SAHELY MUKERJI | OCTOBER 2017
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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BY SAHELY MUKERJI | OCTOBER 2017
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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BY SAHELY MUKERJI | OCTOBER 2017
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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BY ALEX TAIRA | SEPTEMBER 2017
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.
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BY GINA THRONEBERRY | AUGUST 2017
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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BY ALEX TAIRA | AUGUST 2017
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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BY KARA NEWBURY | JUNE 2017
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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BY SAHELY MUKERJI | JUNE 2017
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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BY ROBERT KURTZ | MARCH 2017
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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BY KRISTIN MURPHY | MARCH 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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BY KRISTIN MURPHY | FEBRUARY 2017
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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BY NAWA ARSALA | JANUARY 2017
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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JANUARY 2017
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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BY ROBERT KURTZ | DECEMBER 2016
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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BY SAHELY MUKERJI | OCTOBER 2016
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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COMPILED BY SAHELY MUKERJI | SEPTEMBER 2016
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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BY KARA NEWBURY | AUGUST 2016
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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BY ANDY WHITENER | AUGUST 2016
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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JUNE 2016
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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MAY 2016
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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