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ASC payment modernization act introduced

Ambulatory Surgery Reimbursement Update, October 18, 2005

Representative Wally Herger (R-CA) has introduced legislation that calls for the establishment of a new ambulatory surgery center (ASC) payment system.

The legislation, HR 4042, also seeks to reform the system the Centers for Medicare & Medicaid Services (CMS) uses to determine what procedures Medicare will reimburse ASCs for providing.

Under the draft bill, CMS would pay ASCs 75% of the rate paid to hospital outpatient departments. The bill also seeks to create a list of procedures ASCs would not receive Medicare reimbursement for providing, which would replace the current ASC-list of Medicare-approved procedures.

The American Association of Ambulatory Surgery Centers (AAASC) endorsed the bill in a statement issued last week.

"This legislation is a win/win for the Medicare patient and the Medicare program," said John Duggan, MD, President of AAASC and an orthopedic surgeon.

"It appropriately expands the array of services that are available to the beneficiary in the surgery center," Duggan said. "For every surgical procedure performed in an ASC, the patient incurs a lower copayment and the Medicare program spends less than if the procedure were furnished in the hospital."

The Federated Ambulatory Surgery Association (FASA) is encouraging those in the ASC industry to write their Congress representatives and urge support and to cosponsor the bill.

To view a summary of the bill and a draft letter urging this co-sponsorship, click here.

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