MEMBER PROFILE
Q What are the most important advocacy issues for ASCs going into 2022?
A
By far, the number one issue for advocacy efforts for ASCs in the US is site neutrality. It is unclear the direction that the Biden
administration will take on this matter. Progress was made under the Trump administration, not only in the massive migration of CPT codes to the ASC payable list but also in numerous areas of payment differential between hospital outpatient payments and identical services performed elsewhere. I have had numerous discussions with Representative Bruce Westerman
SCOTT SCHLESINGER, MD Title:
Practice Founder Facility Name:
Legacy Surgery Center City:
Little Rock State:
Arkansas
(R-AR) regarding site neutrality in general and expanding ASC coverage and ASC payments in comparison to hospital outpatient department (HOPD) payments. Congressman Westerman’s support of free-market healthcare and the role of ASCs dates to his days as a state legislator when we first met in 2013. Last year, the congressman proposed a healthcare plan that received support in both the House of Representatives and the Senate, incorporated initiatives from the Trump administration, and was intended to serve as a true bipartisan health reform plan. If you have not had a chance to read his proposal, I encourage you to do so. It was very favorable to improving patient access to ASC care through site neutrality both in terms of coverage and in terms of payment levels. In Arkansas, we are in the midst of a legal battle over a site neutrality
payment law from the 1970s that required equal payment by commercial insurance companies to ASCs as was paid to HOPDs for identical procedures. The opponents have declared the law to be too old to be applicable in 2021. We are cautiously optimistic that we will prevail. In short, the number one advocacy effort should be to dramatically
narrow the payment differential between HOPD payments versus ASC payments for identical procedures. In addition, all procedures that are payable in the HOPD payment system should be payable and covered at an ASC. Lastly, to help achieve a level playing field, we need to also advocate to enforce hospital cost transparency requirements that many hospital systems are ignoring.
22 ASC FOCUS AUGUST 2021 |
ascfocus.org
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