REGULATORY REVIEW
how does CMS effectively evaluate whether to move codes to the ASC- payable list? There is no set process for submitting codes for approval; there is no form to fill out or a set meeting to attend. ASCA has long requested that CMS allows ASCs to perform the same procedures HOPDs can perform since the Conditions of Participation that must be met by HOPDs and the Conditions for Cov- erage for ASCs are nearly identical. While CMS has not been inclined to make what they feel is a big change, the agency has been responsive to ASCA and various specialty groups, industry leaders and organizations when we proactively bring individ- ual procedures to them for review on a more piecemeal basis.
ASCA will continue to work with its member facilities and industry stakeholders to advocate for the expansion of the ASC-payable list.”
—Kara Newbury, ASCA ASCA uses trends found in the
annual procedure list survey it sends to members to determine the codes to pursue. We bring surgeons to the CMS medical officers to present on the safety of specific codes. Although this process is time-consuming, it has been the most successful way to get codes added to the ASC-payable list.
A Timeline of ASCA Advocacy 2012: In the 2013 OPPS/ASC pro- posed rule, released in July 2012, CMS proposed to remove total knee arthroplasty (TKA) from the IPO list. Of the 76 comments that were submitted in response to this pro- posal, however, only two were posi- tive. Due to the overwhelmingly neg- ative response, CMS did not finalize this proposal.
Although the proposal was just to
remove TKA from the IPO list and did not mention the ASC-payable list at the time, ASCA staff realized that we needed to look at the big pic- ture when advocating for codes to be added to the ASC list. We started advocating for adding codes on the HOPD list as well as those that we
ASC FOCUS MAY 2020 |
ascfocus.org
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