MESSAGE FROM THE CEO Highlights of the 2016 Proposed Payment Rule
T
he Centers for Medicare & Medicaid Services (CMS) released the 2016 proposed payment rule for ASCs and hospital outpatient departments
(HOPDs) in July. If the rule is finalized as drafted, ASCs will see an effective update of 1.1 percent—a combination of a 1.7 percent inflation update based on CMS’s estimation of the change in the Consumer Price Index for All Urban Consumers (CPI-U) and a productivity reduction mandated by the Affordable Care Act of 0.6 percentage points. CMS proposes to update the Hospital Outpatient Prospective Payment System (OPPS) rates by -0.1 percent and estimates a -0.2 percent adjustment for hospitals paid under the OPPS in CY 2016. Also, CMS does not take into account sequestration in its proposed rule. This statutory 2 percent reduction remains in effect until at least 2024 unless Congress acts. The continued use of the CPI-U to update ASC reimbursements offers more
evidence of CMS’ unwillingness to recognize that the agency must do more to actively promote ASCs as a high-quality, efficient provider of outpatient care for America’s seniors if we are to survive and thrive in the future. This makes ASCA’s legislative efforts that much more important. The Ambulatory Surgical Center Quality & Access Act of 2015 would move
Download your free 2015 quality reporting tip sheet at
www.ascassociation.org/ 2015QualityReportingRequirements.
Seeking Authors
ASC Focus is seeking the contribution of articles by guest authors. If you have the expertise and time to write for us, we’d be interested in hearing from you. Please see our editorial guidelines at
www.ascassociation.org/Focus and submit your story proposal to
smukerji@ascassociation.org.
6 ASC FOCUS SEPTEMBER 2015
the ASC reimbursement update from CPI-U to the hospital market basket update, which better measures the cost of practicing medicine. For more information and to tell your representative to cosponsor this critical legislation, visit
www.ascassociation.org/govtadvocacy/legislativepriorities/hr1453. In the proposed rule, CMS added 11 new procedures to the ASC list of payable procedures for 2016. Ten of the 11 codes are device intensive; nine of the codes are gynecological surgical procedures. CMS has proposed that all web-based measures in the ASC Quality
Reporting Program be reported by May 15 each year. This year, however, CMS has extended the deadline to September 30 for ASC-6, ASC-7, ASC-8, ASC-9 and ASC-10 measures. Go to
www.ascassociation.org for additional analysis, including a rate calculator
that allows users to determine what ASCs will be paid locally if the proposal is adopted.
Bill Prentice Chief Executive Officer
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