5 CMS Updates for ASCs in 2014

Below are 5 recent legislative and legal updates impacting the ambulatory surgery center industry on the national and state level. 

1. January 1, 2014 marked the beginning of the 2014 Medicare N1 codes. There are 210 new procedures given N1 status by Medicare, most of which were separately paid in previous years. The new regulation applies to the ASC, not the physician, and only for Medicare covered patients. Learn more about the new N1 codes here.

2. The Centers for Medicare and Medicaid Services proposed expanding emergency preparedness requirements at the end of last year. Providers, including ASCs, would be required to: 

  • Develop an emergency plan using an all-hazards approach focusing on capacities and capabilities;
  • Develop and implement policies and procedures based on the risk assessment and emergency plan;
  • Develop and maintain a communication plan complying with federal and state law to coordinate across healthcare providers and with state, local and public health departments and emergency systems;
  • Develop and maintain training and testing programs.

3. The CMS Final Payment Rule includes new quality reporting requirements for cataract surgery. The new requirements include reporting improvement in the patient's visual function within 90 days following cataract surgery, which is a patient reported outcome measure. According to the report, several stakeholders have met with members of Congress to raise issue with the new measure and the potential for unfair penalization under the current rule.

4. In January, MedPAC made the final recommendation for pay rates in 2015, recommending ASCs get no pay raise next year. MedPAC recommended increasing hospital inpatient and outpatient prospective payment systems by 3.25 percent. However, MedPAC also suggested reducing or eliminating the differences between hospital outpatient departments and physician offices for some procedures.

5. It was announced earlier this year that CMS delayed data collection for three new quality measures that were finalized for inclusion in the Ambulatory Surgical Center Quality Reporting Program until April 1. ASCs still need to report data from this year, but instead of reporting for all 12 months only patient encounters from April 1 to Dec. 31 should be included. 

For more information and a complete list of updates please visit Becker's ASC Review.