Message from the President

Do You Have an Emergency Preparedness Plan?

Summer is at an end and it is time to think about emergency preparedness in our centers. Establishing and maintaining a written “all-hazard” disaster preparedness plan for our centers, staff, patients and others in our facilities in the event of an emergency will help us provide a timely and coordinated response in case of an emergency.

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Message from the CEO

Safety First

As you and your surgery center gear up for increasing business in the fall and at the end of the year, the last days of summer can be a good time to make sure your policies and procedures are up to date. ASCA has numerous resources that can help.

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As I See It

Adding Anesthesia as an Ancillary Service

Learn how ASCs make this idea work

As executive vice president of Anesthesia Operations at nimble solutions, I have noticed a growing trend among ASCs and anesthesia providers. Typically, anesthesiologists establish third-party contracts with ASCs. Recently, however, ASCs have begun to embrace anesthesia as an ancillary service.

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Doing Business

Access Workforce Information

Use NPDB’s data bank

Established by Congress in 1986, the National Practitioner Data Bank (NPDB) is a workforce tool that prevents practitioners from moving state to state without disclosure or discovery of previous damaging performance. ASCs may use the NPDB in certain circumstances.

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New Faces in the 118th Congress

Committees of jurisdiction now have different members

With the start of the 118th Congress, ASCA will continue to focus its legislative efforts and meetings on connecting with representatives and senators who serve on the committees to which legislation of interest to the ASC community would be referred upon introduction. These are known as committees of jurisdiction.

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Sg2 2023 Annual Report Forecasts Significant Growth in ASC Volume

GI, ophthalmology and orthopedic procedures will see the highest increases

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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Master Life Safety Code Compliance

Sign up for ASCA’s virtual course this October to learn how

ASCA’s third virtual course this year, Life Safety Code for ASCs, will be broadcast live over two half days, October 23 and 24. Recordings of the sessions will be available on demand later.

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Bryant Receives Nap Gary Award for Lifetime Achievement

The former chief executive officer of ASCA led the organization from 1998–2010

ASCA awarded its 2023 Nap Gary Legacy Award for Lifetime Achievement in the ASC Community to Kathy Bryant, former chief executive officer of ASCA.

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Doing Right by the Community

An Illinois ASC helps patients in need access care

The Orthopaedic Institute Surgery Center in Metropolis, Illinois, helps its community by never sending a child who needs surgery back home without that surgery if the ASC can safely provide it. This is irrespective of the child’s insurance status. Melanie Russell, RN, the administrator of the ASC, is a pivotal part of this effort.

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Hurdles Slowing Down Migration of Procedures

Barriers to moving complex procedures from HOPDs to your ASC

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

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Improve Claim Compliance

Use correct modifiers

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

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Eliminate Common ASC Coding and Billing Compliance Issues

Follow these steps

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

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South Carolina Enacts Major Reform to Certificate of Need Law

Changes eliminate CON requirements for new ASCs

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

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Legal Matters

Informed Consent Process in Ambulatory Surgery

Review state laws and AHRQ materials before creating your policy

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

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Build a Data-Driven Marketing Program

Foster relationships by eliminating the guesswork

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

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Trends in Medical Risk Transfer

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

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

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Reintroducing the ASC Act in Congress

If passed, the Outpatient Surgery Quality and Access Act will better align Medicare’s ASC and HOPD payment systems

As this issue of ASC Focus goes to press, Congressman John Larson (D-CT) and Congressman Brad Wenstrup, DPM (R-OH), are planning to introduce the Outpatient Surgery Quality and Access Act of 2023 in the House side of the 118th Congress, and Senator Richard Blumenthal (D-CT) and Senator William Cassidy, MD (R-LA), are planning to introduce the legislation in the Senate.

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Quality Improvement

Stay on the Forefront of Efficiency and Quality

Consider these new strategies

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

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Air-Cleaning Options for Facility Hygiene

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

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

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Infection Prevention

Build an Effective Infection Prevention Program

Rely on sound policies, careful training and accountability

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

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Preparing for and Responding to a Data Breach

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

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

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Review Key Revenue Cycle Metrics as Your ASC Grows

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

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

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Is Your Billing Team Performing Optimally?

Take a deep dive into your processes to decide

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

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Regulatory Review

Evolution of Emergency Preparedness Requirements

ASC compliance after the COVID-19 PHE

The Centers for Medicare & Medicaid Services (CMS) expects healthcare facilities to be prepared for emergency situations. With the expiration of the COVID-19 public health emergency (PHE) last May, now is a good time for facilities to take stock of CMS’ emergency preparedness requirements, analyze how their emergency plans were executed during the PHE and identify opportunities for improvement.

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Advocacy Spotlight

Create Awareness through Advocacy

TASCS members met their legislators and established ASC Awareness Day

The Texas legislature met from January to May this year and Texas Ambulatory Surgery Center Society (TASCS) members made the most of that time educating their elected officials about ASCs and advocating for policies that support the ASC community.

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Member Profile

Apryl McElheny, RN, CASC

Apryl McElheny, RN, CASC, senior consultant for Progressive Surgical Solutions in Gallitzin, Pennsylvania, shares her best tips on writing an emergency preparedness plan.

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Industry Insight

William A. Miller

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

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Purchase ASCA’s 2023 Virtual Course Bundle

Register now for ASCA’s three 2023 virtual courses. Each course is available for purchase on its own or as part of the 2023 Virtual Course Bundle, a package that gives you three courses for the price of two!

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Web Crawl

Share Your Facility Tour Experience from National ASC Month

If your ASC participated in activities during this year’s National ASC Month in August, let us know.

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