ADVOCACY SPOTLIGHT


of health care as well as any other information that might impact care decisions, such as financial arrangements and clinical guide- lines for treatment;


■■


Medicare, insurers and other payers should encourage beneficiaries and the physicians who refer patients to use lower-cost settings; and


■■


Payers should seek innovative meth- ods, such as tiered co-payments, to incentivize patients to seek care in the most cost-effective setting that is appropriate for their treatment.


Veterans Care Last May, Congress passed and Pres- ident Donald Trump signed the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act. This new law significantly reforms the VA health care system. One provision in the VA MISSION Act, which ASCA endorsed, will require private-sec- tor provider claims to be reimbursed in 30–45 days. This was an important development because private-sector providers nationwide have reported frequent reimbursement delays of 12 months or longer. The VA MISSION Act includes


many other provisions whose imple- mentation in 2019 will be central to ASCA’s legislative strategy. Specifi- cally, VA will be required to: ■■


enter into competitively bid con- tracts to establish networks of care;


■■ ■■


contract with third-party entities to process electronic claims;


enter local agreements that are exempt from basic federal con- tract criteria;


■■ ■■


establish a VA Center for Innova- tion for Care and Payment; and


train VA staff to administer non- VA health programs.


One of the biggest pieces of the


VA MISSION Act will end the Veter- ans Choice Program and establish a new, comprehensive Veterans Com- munity Care Program. Veterans will


still be able to seek private-sector care with a new, streamlined system. The process to start new program- ming will begin in May.


Opioid Crisis Response To help address the opioid epidemic, Congress passed the Substance Use-Disorder Prevention that Pro- motes Opioid Recovery and Treat- ment (SUPPORT) for Patients and Communities Act in fall 2018. Most of the legislation will not impact ASCs, but there are notable pro- grams ASCA will monitor and help inform, when possible. One of the bill’s key provisions directs the US Department of Health and Human Services (HHS) to review and adjust payments under the Medicare Hos- pital


Outpatient Prospective Pay- ment System (OPPS) and Ambula- tory Surgery Center (ASC) Payment System to “avoid financial incentives to use opioids instead of non-opioid alternative treatments.” As leaders in innovative outpatient surgery, ASCs already use non-opioid pain man- agement techniques when clinically appropriate, and changes in Medi- care policy could increase their use in some situations.


Another important provision for ASCs directs HHS to convene a tech-


nical expert panel consisting of med- ical and surgical specialty societies and hospital organizations to recom- mend best practices for pain manage- ment in surgical settings. HHS must issue a report to the public within one year.


Facility Tours One invaluable advocacy tactic ASCA members can employ is to host their federal and state legislators for a facil- ity tour. Facetime with a legislator, while demonstrating the high quality and efficiency that ASCs deliver, can help promote ASC initiatives and pol- icy priorities. Last year, ASCA members hosted


38 facility tours with federal legisla- tors. We want to grow that number in 2019, so visit to help schedule a tour with your senator or representative. Thanks to the hard work and dedi-


cated advocacy from ASCA members across the country, 2018 was a strong year for the ASC community. With a slate of big-ticket policies, 2019 should develop into another year of productive ASC advocacy.


Jeff Evans is ASCA’s assistant director of government affairs, legislative affairs. Write him at jevans@ascassociation.org.


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