ASCA Advocacy in the Pandemic Quick action to tackle COVID-19 challenges bears fruit BY KARA NEWBURY

Editor’s note: This is the first part of a two-part column. Look for the sec- ond part in the January 2021 Regula- tory Review.

On February 27, 2020, ASCA staff advocated for payment policy changes with senior level executives with the Centers for Medi-

care & Medicaid Services (CMS) at the US Department of Health and Human Services (HHS) offices in Washington, DC. Just two months into the new year, this ended up being our last “routine” meeting for 2020—the last one that did not center around the 2019 novel coro- navirus (COVID-19). While COVID-19 had been declared a public health emer- gency by HHS Secretary Alex Azar on January 31, the last week of February was when federal efforts became more public, as a task force was announced from HHS headquarters the same day we were there. Two weeks later, Presi- dent Donald Trump declared a national state of emergency, and ASCA’s efforts accelerated rapidly to advocate for the role that ASCs could play during the public health emergency (PHE) and the resources needed to allow our facilities to continue to provide high-quality and safe outpatient surgery during the PHE and beyond.

Timeline of Developments in March and April

FRIDAY, MARCH 13 American College of Surgeons (ACS) recommends pause for elective procedures in hospitals in face of

national emergency ■

President Trump declared a national state of emergency for COVID-19 under Section 201 and 301 of the National Emergencies Act (NEA). This allows the secretary of HHS

this time. ASCA reported that it had “consulted with clinical experts in our community and the consensus position is that ASCs can continue to provide safe surgical care for patients whose condition cannot wait until hospitals return to normal opera- tions.” ASCA then urged government officials to allow ASCs to remain open for elective urgent surgeries.

to exercise the authority under sec- tion 1135 of the Social Security Act (SSA) to temporarily waive or modify certain requirements of the payment programs under HHS’ purview, including Medicare. Sec- tion 1135 waivers, as they are com- monly referred to, can loosen certain requirements for healthcare provid- ers to improve their response efforts.

At the same time, pressure was being put on healthcare providers to post- pone or cancel elective procedures in hospitals. ACS released recom- mendations for management of elec- tive surgical procedures and essen- tial resources during the COVID-19 pandemic. ACS recommended hos- pitals, health systems and surgeons enact plans to minimize, postpone or cancel elective operations until healthcare providers are “confident that our healthcare infrastructure can support a potentially rapid and over- whelming uptick in critical patient care needs.”


ASCA outreach ramps up ■


ASCA released its first public state- ment on the role of ASCs during

ASCA sent a letter to Azar, stat- ing that the industry would like to be of service during COVID-19. “ASCs can serve as alternative set- tings that provide surgical care for those patients who would suffer from a delay, while allowing our local hospital partners to create the incremental capacity needed during these dynamic times. As the pan- demic progresses, we will continue to assess our approach, in coordi- nation with experts throughout the healthcare system, to best serve the needs of patients and communities.”

WEDNESDAY, MARCH 18 CMS releases adult elective surgery and procedures recommendations. CMS recommended limiting all non-essential planned surgeries and procedures, including dental, until further notice. “To aggressively address COVID-19, CMS recognizes that conservation of critical resources such as ventilators and Personal Protective Equipment (PPE) is essential, as well as limiting exposure of patients and staff to the SARS- CoV-2 virus. Attached is guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures. These considerations will assist in the management of vital healthcare resources during this public health emergency.”

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