REGULATORY REVIEW


of the industry on June 16, 2014. Two areas of concern were: ■


Both measures are fully developed


§ 416.44(b)(6): Windowless Anes- thetizing Locations—This pro- posal would require the ASC to have a supply and exhaust system that “(i) Automatically vents smoke and products of combustion, (ii) Prevents recirculation of smoke originating within the surgical suite, and (iii) Prevents the circulation of smoke entering the system intake.” This has never been required for ASCs, and for hospitals, NFPA deleted the requirement for such systems about a decade ago. In addition to the high cost for centers to comply, we are concerned that making these exhaust vents effective would require the shutdown of the air handling units which would likely shut down ven- tilation to multiple operating rooms and, thus, increase the possibility of surgical site infections. ASCA asked that this proposal be withdrawn.


■


Fire Protection Requirements— The 2012 edition of Chapter 8 stip- ulates that all penetrations of a fire- rated wall or floor must be protected by an “Approved Fire Stop System or Device,” instead of simply offering protection equivalent to the surfaces penetrated. This requirement would result in higher costs for new facilities required to use proprietary devices or systems. If CMS requires an existing facility to meet this new standard, the cost implications could be even greater as existing wires and other penetrating elements would need to be removed then reinstalled as nec- essary to comply. ASCA requested that existing facilities be exempted from this requirement.


Quality Reporting CMS did not add any new measures to the ASC Quality Reporting (ASCQR) Program in the 2016 payment rule but invited public comment on two mea- sures developed by the ASC Quality


22 ASC FOCUS JANUARY 2016


CMS did not add any new measures to the ASC Quality Reporting Program in the 2016 payment rule but invited public comment on two measures developed by the ASC Quality Collaboration.”


—Kara Newbury, ASCA


Collaboration (ASC QC), which spear- heads measure development activities for the industry. The agency states in the rule that it might consider these measures for future inclusion in the ASCQR Program.


Normothermia and Unplanned Anterior Vitrectomy The Normothermia Outcome measure assesses the percentage of patients having


surgical procedures under


general or neuraxial anesthesia of 60 minutes or more in duration who are normothermic within 15 minutes of arrival in the post-anesthesia care unit. The Unplanned Anterior Vitrectomy measure assesses the percentage of cataract surgery patients who have an unplanned anterior vitrectomy.


Track the Latest Regulatory and Legislative News for ASCs


Visit ASCA’s web site every week to stay up to date on the latest government affairs news affecting the ASC industry. Every week, ASCA’s Government Affairs Update newsletter is posted online for ASCA members to read. The weekly newsletter tracks and analyzes the latest legislative and regulatory developments concerning ASCs.


www.ascassociation.org/ GovtAffairsUpdate


and have been specifically tested in the ASC setting. The Measure Applica- tions Partnership (MAP) reviewed the measures last year and gave them con- ditional support pending endorsement by the National Quality Forum (NQF); reliability testing was completed in 2014 with very strong results, which were shared with CMS at that time.


Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey Although not included in the 2016 payment rule, the Consumer Assess- ment of Healthcare Providers and Sys- tems Outpatient and Ambulatory Sur- gery Survey (OAS CAHPS) is another measure that ASCA anticipates will be required of ASCs in the future. In 2016, CMS plans to roll out a


voluntary program in which ASCs and HOPDs will be invited to participate in OAS CAHPS by contracting with a CMS-approved, third-party vendor of their choosing to implement the sur- vey—currently 37 questions long— on their behalf and submit the data to CMS. During this stage, facilities will be required to pay for the data collec- tion through the third-party vendors. The ASC QC has made detailed recommendations when opportunities for public comment have been offered during the survey development pro- cess and proposed ways to shorten the survey and make its administration less burdensome for our facilities. The ASC QC and ASCA will continue to monitor CMS progress toward national implementation and provide feedback as opportunities present themselves. These are just a few areas in which


ASCA expects further regulatory guid- ance in the coming year. Pay close attention to your email inbox, this magazine, upcoming ASCA webinars and meetings for updates.


Kara Newbury is ASCA’s regulatory counsel. Write her at knewbury@ascassociation.org.


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