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Proposed CMS updates could make ASCs more accessible for seniors

Ambulatory Surgery Reimbursement Update, November 23, 2004

The proposed changes to Medicare announced last Friday could offer America's rapidly-growing senior citizen population greater access to procedures performed in ambulatory surgery centers, according to the Federated Ambulatory Surgery Association (FASA).

According to a release issued by FASA, the proposed addition of 25 procedures to the Centers for Medicare and Medicaid Services' (CMS) ASC payment list (which includes surgeries like knee arthroscopy and bladder defect repair) represent a widening of availability of service to the elderly, allowing ASCs to participate in meeting the surgical demands of an exploding population.

However, FASA officials still expressed disappointment that, despite the new additions, CMS has yet to offer reimbursement and coverage for other procedures performed at ASCs-such as lesion removal and detached retina surgery-that other health plans do cover. There is also concern that CMS will be performing a review that could lead to their decision to remove certain covered ASC procedures from their list, making the new proposed changes a case of one step forward and one step back.

"Adding procedures to the ASC list is good news for both Medicare beneficiaries and the Medicare program," said FASA Executive Vice President Kathy Bryant. "ASCs save both Medicare and patients money through lower premiums and co-payments. There are many procedures being performed in ASCs that meet Medicare's requirements, but are just not on the Medicare list. It's time to include them."

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