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MEDICARE MONITOR


Looking Ahead What can you expect this summer and beyond? BY JONATHAN BEAL


T


o borrow a line often attributed to Yogi Berra, “It is hard to make predictions, especially about the fu- ture.” This is particularly true in the current world of health care policy. With that in mind, this article pro- vides a best guess about what ASCs can expect from Medicare this sum- mer and beyond.


New Quality Reporting Requirement Goes into Effect This summer, ASCs will be required to report their 2012 volume of certain procedures as well as whether they used a safe surgery checklist at any point in 2012. ASCs will report this information via the QualityNet web site (www.QualityNet.org) during the 1½-month reporting window that will be available July 1 to August 15. ASCs can prepare before the re-


porting period begins by registering to use the QualityNet site and famil- iarizing themselves with how to use it. A recorded Centers for Medicare & Medicaid Services (CMS) webinar that


shows how to use the site is available on the QualityNet web site. Addition- ally, ASCs should determine their 2012 volume of the specified CPT codes so that they have that information avail- able when reporting commences.


Proposed 2014 payment policies This summer also will bring the re- lease of CMS’ proposed 2014 ASC Medicare rates and policies. If there are procedures that you are currently providing to non-Medicare patients that you would like to perform on Medicare beneficiaries, please let ASCA know so that we can advocate for their addition. This summer’s proposal might also contain additional quality reporting re- quirements as the program gets ready to enter its third year. ASCA will pres- ent a webinar on August 13 outlining the proposed changes. For more infor- mation on that webinar and other webi- nar programs available from ASCA, go to www.ascassociation.org/Webinars.


Revision of Who at an ASC is Allowed to Supervise Radiological Services In a major victory for ASCs, CMS is expected to change the requirement that a radiologist, who is a member of an ASC’s medical staff, supervise the pro- vision of radiologic services. ASCA has long advocated for this change noting that requiring ASCs to have a radiologist on staff does not make sense, given that radiologic services in an ASC are gener- ally limited to intra-operative guidance that does not require interpretation by a radiologist. Additionally, ASCs have re- ported difficulty in finding radiologists who are willing to be part of their medi- cal staff. CMS estimates that the change will save ASCs $41 million annually.


Continued Focus on Fraud and Abuse The federal government recovered $4.2 billion in erroneous payments to health care providers in 2012. With mounting pressures to rein in Medicare spend- ing, efforts to identify overpayments as a result of fraud or simple mistake are likely to continue.


Ongoing Debate over the Future of Medicare As this article goes to press, the debate over the nation’s budget continues in Washington. At the center of the de- bate is what to do about the politically intractable problem of runaway Medi- care spending. It is unlikely that the summer will see resolution to the prob- lem of Medicare spending, but chang- es that could have a very real impact on how ASCs do business might be on the horizon as the federal government tries to curb Medicare spending. No matter what transpires this sum-


mer, it will be critical for ASCs to re- main involved in the debate as the na- tion’s health care system continues to evolve. This year, ASCA is sponsoring a series of Capitol Fly-Ins that give all ASC professionals a chance to par- ticipate. For more information, go to www.ascassociation.org/2013FlyIns.


22 ASC FOCUS MAY 2013


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