MEDICARE MONITOR
thalmic ambulatory payment classifica- tions (APC), two pain APCs and one skin APC. ASCA believes it is prob- lematic that the equalization occurs at the APC level instead of the CPT level, thereby capturing procedures that are not commonly done in an ASC. ASCA has prepared a written response to this chapter and shared it with MedPAC staff and commissioners, as well as a few congressional staffers. In a separate analysis, MedPAC pro- posed equalizing payments between HOPDs and physician offices for cer- tain procedures, including four pain APCs (203, 204, 206 and 207). That analysis was based on the volume of procedures done in the HOPDs and physician offices and excluded volume done in ASCs. The report recommend- ed reducing the payments for these and 62 other APCs to either the physician
ASCA continues to try to educate MedPAC’s commissioners on the benefits of the ASC setting and the cost-savings that
can be realized if Medicare policies promote the migration of services to the lower-cost, high-quality setting.”
—Kara Newbury
office level or to a new hybrid rate that would account for packaged services provided as part of the procedure. Al- though ASCs were not part of this analysis, ASCA remains concerned that any reductions in the HOPD payment for these services would be applied to services provided in the ASC setting. In addition, ASCA has recommended that MedPAC evaluate all procedures over the three settings—hospital, ASC and physician office—instead of having two separate proposals.
What Now?
ASCA continues to try to educate Med- PAC’s commissioners on the benefits of the ASC setting and the cost-savings that can be realized if Medicare policies promote the migration of services to the lower-cost, high-quality setting. Watch for updated information on MedPAC’s proposals, the ways that ASCA is advo- cating for you and ways that you can get involved in the weekly Government Af- fairs Updates e-newsletters that ASCA sends to its members.
ASC FOCUS NOVEMBER/DECEMBER 2013
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