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REGULATORY REVIEW


related to Medicare payment, includ- ing aligning ASCs with the hospi- tal inflationary update factor and a slew of advanced surgical pro- cedures newly payable for ASCs. More broadly, every ASC can bene- fit from an awareness of the funda- mental federal regulations impacting ASCs. Understanding the Medicare Conditions for Coverage (CfCs) is essential to Medicare certification, and understanding basic federal reg- ulations such as the Health Insur- ance Portability and Accountability Act of 1996 (HIPAA) and emergency preparedness guidelines is invalu- able regardless the site of service. This session, featuring ASCA Gov- ernment Affairs Director and Regu- latory Counsel Kara Newbury, will provide the foundation every center needs to understand their federal reg- ulatory obligations and best practices for compliance.


How CMS Can Impact Surgery Migration to ASCs and Commercial Payer Contracting When: Friday, May 15, from 10:30 am –12:00 pm


While this session does not directly target regulatory compliance, it will provide a deep understanding of the way ASC reimbursement—both pub- lic and private—is calculated and the many levers that can drive surgical volume. Naya Kehayes is one of the foremost experts on ASC reimburse- ment, an ecosystem so complicated that even many who have worked in the industry for years do not under- stand it entirely. In this advanced session, you will dive deep into the emerging trends in Medicare reim- bursement, such as designation of device-intensive procedures and pro- cedures subject to multiple procedure discounting, and the effects these des- ignations have on surgery site of ser- vice over time. Although it might seem that public and private payment


ASC quality reporting is an essential task for any center performing significant volume on Medicare patients. ASCs that fail to report correctly could receive up to a 2 percent reduction in their Medicare payments.”


—Alex Taira, ASCA


are distinct entities, the decisions that CMS makes regarding Medicare reim- bursement often have deeper implica- tions than those that are immediately apparent. With new complex surgical procedures being added to the ASC- payable list every year, this session could be invaluable in helping you chart the smartest, most financially beneficial course for your ASC.


Your Guide to CMS Emergency Preparedness Compliance When: Friday, May 15, from 3:45 pm –5:15 pm


In September 2016, CMS posted a final rule that established new national emergency preparedness require- ments for all Medicare and Medicaid supplier types. The rule created man- datory elements and planning proce- dures that facilities must institute to account for facility occupant safety in the event of natural and man-made emergencies. This includes an “all- hazards” approach to risk assess- ment and planning, a requirement that facilities develop discrete poli- cies and procedures, written emer-


gency plans that describe how care coordination can continue in the event of an emergency, and manda- tory training and testing exercises. Surveyors began surveying based on these requirements on November 15, 2017. Some of these requirements, however, already have been altered by the Burden Reduction Final Rule that took effect November 29, 2019. This session will guide you through all the latest requirements so that you can ensure that your facility is well- equipped to handle an emergency and, thus, avoid a regulatory citation. Many other sessions and break-


outs will touch on regulatory top- ics as well, and some of the best advice you will get at this meeting will likely come from interacting with your peers. Additionally, ASCA Government Affairs staff will be on site at the ASCA booth in the exhibit hall to answer your questions. We look forward to seeing you in Orlando.


Alex Taira is ASCA’s regulatory policy and research manager. Write him at ataira@ascassociation.org.


ASC FOCUS MARCH 2020| ascfocus.org 23


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