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Ambulatory Surgery Reimbursement Update

Ambulatory Surgery Regulation Update is a weekly e-mail newsletter that offers news and stories about regulatory issues in ambulatory surgery, like certificate of need legislation and physician ownership issues, presented in a "quick-read" format. You'll also receive links to industry reports as available.

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Ambulatory Surgery Reimbursement Update

Issue 50, December 26, 2006

• ASC Quality Collaboration supports Congress's quality information initiative

  The ASC Quality Collaboration has announced its support of Congress's initiative to make quality...

• Surgeons fight to open surgical hospital

  A group of physicians in Ohio are fighting to open a surgical hospital despite state and local...

• JCAHO to change name to 'The Joint Commission'

  The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) plans to change its name...

Issue 49, December 19, 2006

• ASC seeks to become state's first surgical hospital

  An ambulatory surgery center (ASC) applied last week to become Missouri's first specialty surgical...

• Lack of NPI preparedness could lead to payment disruptions

  Although the healthcare industry is making significant progress toward meeting the May 23, 2007...

• PHA (formerly ASHA) launches Web site

  Physician Hospitals of America (PHA), formerly the American Surgical Hospital Association (ASHA...

Issue 48, December 14, 2006

• Congress stops Medicare physician payment cut

  The American Medical Association (AMA) is praising the efforts of Congress in averting the 5...

• AAASC praises quality reporting initiative

  The American Association of American Surgery Centers (AAASC) praised Congress for a provision that...

• Article highlights cost-saving of ASCs

  The Chicago Sun-Times featured a column last week highlighting the cost-saving benefits and growth...

Issue 46, November 30, 2006

• CMS makes HOPD payment information available

  The Centers for Medicare & Medicaid Services (CMS) issued payment information last week for 81...

• NQF approves AAASC membership

  The National Quality Forum (NQF) has approved the American Association of Ambulatory Surgery...

• Majority of physicians assume public roles

  Approximately two-thirds of physicians participate in activities such as community outreach...

Issue 45, November 21, 2006

• Plastic surgery societies celebrate silicone breast implant approval

  The American Society for Aesthetic Plastic Surgery (ASAPS) and The American Society of Plastic...

• ASC Coalition publishes report on value of surgery centers

  The Ambulatory Surgery Center (ASC) Coalition, an assembly of national and state ambulatory...

• Press Ganey recognizes eight ambulatory surgery organizations

  Press Ganey Associates, Inc. announced its 2006 award-winning healthcare organizations last week...

Issue 44, November 15, 2006

• ASC associations submit comments to CMS regarding proposed 2008 changes

  The major ambulatory surgery center (ASC) associations submitted comments last week to the Centers...

• Web site allows residents to compare facilities, health plans

  A new Web site allows residents of Florida to see data on conditions and procedures related to...

• Article discusses growth and impact of surgery centers in Lehigh Valley

  An article from The Morning Call discusses the development and affect of new surgery centers and...

Issue 43, November 7, 2006

• OPPS final rule brings ASC list additions, reimbursement cuts

  The Centers for Medicare & Medicaid Services (CMS) issued its final rule for the 2007 outpatient...

• Study: Little variation between costs of services in outpatient settings

  A new study reveals little difference between the cost and quality of three different procedures...

• CMS cuts physician payments by 5%

  The Centers for Medicare & Medicaid Services (CMS) 2007 outpatient prospective payment system...

• CMS cuts physician payments by 5%

  The Centers for Medicare & Medicaid Services (CMS) 2007 outpatient prospective payment system...

Issue 42, November 1, 2006

• ASCs urged to submit comments on proposed 2008 changes

  Ambulatory surgery center (ASC) leaders are asking for help to shape legislation that will affect...

• Industry associations send letters to CMS concerning 2007 proposals

  Several associations submitted comments to the Centers for Medicare & Medicaid Services (CMS...

• CCHIT certifies 11 ambulatory EHR products

  The Certification Commission for Healthcare Information Technology (CCHIT) approved 11 new...

Issue 41, October 24, 2006

• Florida court decisions could pave way for faster, proper insurance payments

  The Florida Supreme Court ruled October 19 that a group of doctors can sue two insurers over...

• PainCare Holdings to sell stake in ASCs

  PainCare Holdings Inc., an Orlando-based operator of ambulatory surgery centers (ASCs), announced...

• CMS to test pay for performance in small practices

  The Centers for Medicare & Medicaid Services (CMS) announced plans on October 13 for a new...

Issue 40, October 18, 2006

• Hospital, insurer dispute is surgery centers' gain

  Ambulatory surgery centers (ASC) in Denver are seeing an increase in patients as a result of a...

• Pennsylvania sees growth in surgery center numbers

  The number of surgery centers in Pennsylvania has surged over the past decade, with the total...

Issue 39, October 10, 2006

• Final day to comment on proposed ASC payment rule

  Today is the deadline to submit comments to the Centers for Medicare & Medicaid Services on the...

• Surgery center, joint supplier settle with Medicare

  The Siouxland Surgical Center in Dakota Dunes, South Dakota, and its artificial joint supplier will...

• NovaMed acquires eighth ASC in '06

  NovaMed has acquired its eighth ambulatory surgery center (ASC) in 2006, according to a press...

Issue 38, October 3, 2006

• AAASC issues state advocacy update

  The American Association of Ambulatory Surgery Centers (AAASC) posted its latest AAASC State...

• AMA urges action on physician payment cut

  The chair of the American Medical Association (AMA) expressed concern that Congress is heading home...

• OIG releases 2007 Work Plan

  The Deficit Reduction Act of 2005 (DRA) is a prominent theme of the 2007 Office of Inspector...

Issue 37, September 26, 2006

• CMS issues updated data file for proposed payment system

  The Centers for Medicare & Medicaid Services (CMS) has posted an updated data file that ambulatory...

• Surgery center companies hit hard on Wall Street

  Several surgery center companies saw their stock prices take a significant hit last week after Bank...

• Study provides data on specialty mix, hourly wages at ASCs

  A new study on the financial and operating performance of multi-specialty, licensed, freestanding...

Issue 36, September 20, 2006

• Physicians plan for major changes if Medicare cuts proceed

  Thirty-nine percent of medical group practices said they may be forced to limit the number of...

• Medicare reimbursement hold starts Friday

  The temporary 9-day freeze of Medicare reimbursements to physicians, hospitals, and other providers...

• Virginia rejects two applications to build surgery centers

  Two hospitals' applications to build ambulatory surgery centers in the Isle of Wight in Virginia...

Issue 35, September 13, 2006

• ASC leaders form group to determine quality measures

  Prominent members of ambulatory surgery center (ASC) associations and companies have formed a group...

• Medicare to hold provider payments for nine days

  Congress has approved a Medicare "holiday" during which physicians, hospitals, and other providers...

• Administrator of CMS to resign in October

  Mark B. McClellan, MD, PhD, who has served as the administrator for the Centers for Medicare...

Issue 33, August 31, 2006

• CMS makes available Medicare payment information for 61 ASC procedures

  The Centers for Medicare & Medicaid Services (CMS) issued payment information last week for 61...

• Imaging services would take hit under proposed rules

  The nation's largest medical device organization is working to temporarily halt provisions in the...

• Bush issues order for healthcare pricing transparency

  President Bush issued an executive order to federal agencies providing healthcare coverage that...

Issue 32, August 22, 2006

• AAASC creates proposed rule resource Web page

  The American Association of Ambulatory Surgery Centers (AAASC) recently developed a Web page...

• Senator pleased with end to specialty hospital moratorium

  Senator Mike Crapo (R-ID) issued a statement in support of CMS lifting the ban on the construction...

• Paper analyzes Medicare growth rate decrease

  The rate of "excess" growth in Medicare spending per beneficiary (i.e., growth beyond the combined...

Issue 31, August 15, 2006

• CMS proposes major overhaul of ASC payment system in 2008

  The Centers for Medicare & Medicaid Services (CMS) last Tuesday issued its proposed rule outlining...

• CMS issues final specialty hospital report required by DRA

  The Centers for Medicare & Medicaid Services (CMS) issued a final report to Congress that provides...

• National ASC Open House Day held today

  Ambulatory surgery centers (ASC) throughout the country are participating in FASA's fourth annual...

Issue 30, August 11, 2006

• Specialty hospital moratorium ends today

  The medical community continues to speculate about the effects of the end of the almost three-year...

• EHR technology receives safeharbor guidelines

  The Department of Health & Human Services (HHS) has announced final regulations governing...

• Legislation proposed to ban physician referrals to same-physician-owned faciliti

  A senator in Pennsylvania has proposed legislation that would ban physicians from referring their...

Issue 29, August 2, 2006

• AMA survey, GAO report show contrasting affect of Medicare cuts

  Nearly half (45%) of physicians surveyed by the American Medical Association (AMA) say they will...

• Specialty hospital construction moratorium expires next week

  Despite the federal moratorium on specialty hospital construction expiring on August 8, industry...

• ASC Open House Day is August 15

  The National Ambulatory Surgery Center (ASC) Open House Day is August 15.

Issue 28, July 18, 2006

• New ASC payment plan announcement coming soon

  The Centers for Medicare & Medicaid Services (CMS) is expected to announce its new payment plan for...

• Commission certifies first ambulatory EHR products

  The Certification Commission for Healthcare Information Technology (CCHIT) has certified the first...

• FASA challenges AHA report as biased against ASCs

  Responding to the July edition of the American Hospital Association's (AHA) TrendWatch publication...

• Task force to address future of outpatient centers

  Massachusetts plans to create a task force to address the future of imaging and surgical centers...

• Physicians will open surgery center despite hospital dispute

  A group of physicians in Festus, MO, will proceed with developing and opening an outpatient surgery...

• Founder of National Surgical Care dies

  The cofounder of National Surgical Care (NSC) died July 16 following a brief illness, according to...

Issue 27, July 11, 2006

• Medicare announces temporary payment freeze in September

  Providers and physicians filing claims September 22-September 30 will receive payment October 2...

• AAASC issues State Advocacy Updates

  The American Association of Ambulatory Surgery Centers (AAASC) issued two editions of its State...

• U.S. News runs story on state of ambulatory industry

  The July 17 edition of U.S. News & World Report will contain a story discussing the rise in...

Issue 26, July 4, 2006

• Senate bars ASC development near rural hospital

  The Louisiana Senate has approved a bill that discourages the development of healthcare facilities...

• CCHIT to release certification results

  The Certification Commission for Healthcare IT (CCHIT) on July 18 plans to announce the first group...

• Insurer encourages ASC-based colonoscopies

  The San Fransisco Chronicle published an editorial defending cost-control measures by Blue Cross of...

Issue 25, June 27, 2006

• Hospitals to target outpatient facilities with restrictive legislation

  Despite a failed attempt to propose a moratorium on new physician-owned surgery centers in Idaho...

• Senator Clinton to introduce privacy legislation

  A privacy bill of rights that better enforces medical privacy protections and sets clear rules on...

• CDC conducts National Survey of Ambulatory Surgery

  The Centers for Disease Control and Prevention (CDC) is conducting a National Survey of Ambulatory...

Issue 24, June 20, 2006

• AMA addresses insurer transparency, treatment plans, influenza

  The American Medical Association (AMA) adopted new policies addressing health plan and insurer...

• ASAPS posts injectables quick facts spreadsheet

  The American Society for Aesthetic Plastic Surgery (ASAPS) has created a spreadsheet of quick facts...

• Voluntary compliance policy to remain for security, NPI rules

  CMS will "for the foreseeable future" continue to seek voluntary compliance with the security and...

Issue 23, June 14, 2006

• Governor visits new surgery center

  The governor of Utah visited a nine-month-old ambulatory surgery center (ASC) last week to tour the...

• BlueCross sued for paying docs in ASCs more than hospitals

  The California Hospital Association (CHA) is suing BlueCross of California over a policy the CHA...

• CMS to post payment information for common ASC procedures

  The Centers for Medicare & Medicaid Services (CMS) will post payment information for common...

Issue 22, June 6, 2006

• ASC leaders meet with CMS administrator

  Leaders in the ambulatory surgery center (ASC) community met with Mark McClellan, MD, administrator...

• AAASC creates proposed rule resource Web page

  The American Association of Ambulatory Surgery Centers (AAASC) recently developed a Web page...

• No fines levied from HIPAA privacy law violations

  Despite receiving more than 19,000 alleged violations of the HIPAA privacy law over the past three...

• ASC community takes on Washington

  Members of the ambulatory surgery center (ASC) community, including administrators and physician...

Issue 21, May 31, 2006

• ASC takes heat for keeping patients overnight

  A Kentucky facility licensed as an ambulatory surgery center (ASC) is under scrutiny from the...

• Florida Supreme Court says antikickback statute unconstitutional

  The Florida Supreme Court has found that the state’s antikickback statue is unconstitutional...

• AMA travels country to raise awareness of Medicare cuts

  The American Medical Association (AMA) made stops in several cities in Connecticut last week as...

Issue 20, May 23, 2006

• CMS will not extend specialty hospital moratorium

  CMS Administrator Mark McClellan, MD, PhD, told the House Energy and Commerce Subcommittee on...

• FASA separates into two entities

  The Federated Ambulatory Surgery Association (FASA) divided into two distinct legal entities on May...

• New CMS enrollment applications include national provider identifier

  CMS introduced revised CMS 855 Medicare provider enrollment applications on May 1. The...

Issue 19, May 16, 2006

• Medical liability reform bill fails to reach U.S. Senate vote

  A filibuster kept a controversial medical liability reform bill, the Medical Care Access Protection...

• CMS clarifies Medicare payment policy on implants and prosthetics

  CMS issued a transmittal May 5 that clarifies Medicare's policy on the payment and billing of...

Issue 18, May 9, 2006

• Medicare to exhaust itself financially by 2018

  The Centers for Medicare & Medicaid Services (CMS) released its annual Medicare Trustees Report...

• HIPAA-mandated NPI bulk enumeration begins this month

  Healthcare organizations can now begin submitting applications for the Health Insurance Portability...

• Senate expected to vote on medical liability reform bill

  The U.S. Senate was expected to vote on the Medical Care Access Protection Act of 2006 yesterday...

Issue 17, May 2, 2006

• HHS releases letter addressing compliance issues

  The Department of Health & Human Services (HHS) has issued a three-page letter to healthcare...

• Report states rural community hospitals losing money to ASCs

  A recent report by professors from the Tulane University School of Public Health Department of...

• CMS announces $50 payment adjustment for NTIOLs

  The Centers for Medicare & Medicaid Services (CMS) has announced an additional $50 payment for New...

Issue 16, April 25, 2006

• Lawmaker seeks investigation into insurers and hospitals

  At a press conference organized by the Colorado Ambulatory Surgery Center Association, a state...

• Memorandum issued to NYSAASC members

  New York regulators must recognize ambulatory surgery centers’ (ASCs) rights to operate in...

• Newspapers detail fight between hospitals and surgery centers

  Newspapers ran stories over the past week detailing the ongoing struggle between hospitals and...

Issue 15, April 19, 2006

• No new CMS position on pain procedures, FASA reports

  The Federated Ambulatory Surgery Association (FASA) has learned from the Centers for Medicare...

• Hospitals, medical entrepreneurs fight over CON law

  A fight is on between hospitals and a group of medical entrepreneurs over Alaska’s...

• AAAHC and AAASC elect new officers at annual meetings

  The Accreditation Association for Ambulatory Health Care (AAAHC) and American Association of...

Issue 14, April 11, 2006

• FASA seeks clarification from CMS concerning pain procedures

  The Federated Ambulatory Surgery Association (FASA) is asking any ambulatory surgery centers (ASCs...

• Bill addresses bariatric surgery concerns

  Indiana legislators passed a bariatric surgery bill that addresses problems with the state's...

• Congressman to introduce electronic health information privacy bill

  A Rhode Island congressman has said he will introduce legislation to help protect the privacy of...

Issue 13, April 5, 2006

• Battle rages for contracts in Colorado between hospitals and ASCs

  Ambulatory surgery centers (ASCs) in Colorado are accusing hospitals of influencing insurers to not...

• Medicare to stop mailing SPR for providers also receiving ERA

  Medicare will stop mailing standard paper remittance (SPR) for providers and suppliers that are...

• CMS releases 2006 jurisdiction list for HCPCS claims

  The Centers for Medicare & Medicaid Services (CMS) has released the 2006 jurisdiction list for HCFA...

Issue 12, March 28, 2006

• AAASC files antitrust protection brief with Supreme Court

  The American Association of Ambulatory Surgery Centers (AAASC), along with the Outpatient...

• Free special report on HIPAA final enforcement rule

  The HIPAA final enforcement rule took effect March 16. Organizations looking for help in...

• Celebrate Doctors Day March 30

  This year's annual Doctors Day, observed on March 30, will promote emergency preparedness...

Issue 11, March 21, 2006

• FASA files antitrust protection brief with Supreme Court

  The Federated Ambulatory Surgery Association (FASA), along with several supporting associations...

• Congresswoman expected to visit Connecticut ASC

  Congresswoman Nancy Johnson (R-CT) was scheduled to tour the Endoscopy Center of Northwest...

• CMS warns of Medicare phone scam

  The Centers for Medicare & Medicaid Services (CMS) has issued a press release warning seniors about...

Issue 10, March 7, 2006

• AMA supports MedPAC's physician payment recommendation

  The American Medical Association (AMA) has issued a statement in support of the Medicare Payment...

• NH passes bill requiring ASCs to report infection stats

  A bill was passed last week by the New Hampshire House of Representatives requiring state...

• AQA to launch program to measure physician performance

  The Ambulatory Care Quality Alliance (AQA) plans to launch a pilot program in six US regions to...

• CMS provides three new NPI resources

  Those looking for more guidance on national provider identifiers (NPIs) can find three new...

• List of doctor, outpatient prices in Milwaukee is available through Humana plan

  More than 44,000 people in a new Humana, Inc. plan now have access to the most extensive...

• Birth control procedure receives extended Medicaid coverage

  A nonincisional Essure® permanent birth control procedure, developed by Conceptus, Inc., is now...

Issue 9, February 28, 2006

• CCHIT schedules EHR certification conference call

  The Certification Commission for Healthcare Information Technology (CCHIT) has scheduled a...

• Number of surgical cosmetic procedures increases one percent

  The number of cosmetic surgical procedures increased by 1% in 2005 compared to 2004, according to a...

• Medicare to cover three forms of obesity surgery

  Medicare has agreed to pay for three forms of bariatric surgery at facilities that have been...

Issue 8, February 21, 2006

• FASA backs Bush’s call for pricing transparency

  A Federated Ambulatory Surgery Association (FASA) board member addressed President Bush last week...

• AAASC offers Web-based payment calculator

  In anticipation of the transition of Medicare payments from the current ASC payments system to one...

• HHS publishes HIPAA final enforcement rule

  The Department of Health and Human Services (HHS) in the February 16 Federal Register published...

Issue 7, February 14, 2006

• CMS administrator pledges support for ASCs

  The administrator for the Centers for Medicare & Medicaid Services (CMS) pledged support for...

• Bill introduced to repeal NJ tax on cosmetic procedures

  A bill to repeal New Jersey's cosmetic surgery tax was introduced in the state by the same...

• OSHA strong on enforcement in 2005

  The Occupational Safety & Health Administration (OSHA) sustained a vigorous enforcement program...

Issue 6, February 7, 2006

• CMS to pay $50 more for some NTIOLs

  CMS has announced that it will reimburse an additional $50 under Medicare for intraocular lenses by...

• House gives final approval to Deficit Reduction Act

  On February 1 the U.S. House of Representatives approved the Deficit Reduction Act of 2005...

• ACS boycotting state until CON law amended

  The American College of Surgeons (ACS) will not consider Georgia a potential site for any of its...

Issue 5, January 31, 2006

• HSC, AMA square off on value of specialty hospitals

  The Center for Studying Health System Change (HSC) and the American Medical Association (AMA...

• Letter requests more time for providers to comply with claims attachment rule

  The Centers for Medicare & Medicaid Services (CMS) should stagger the compliance deadlines for the...

• USPI to buy Surgis

  United Surgical Partners International (USPI) will buy Surgis Inc., according to a news release on...

Issue 4, January 24, 2006

• House to vote on Medicare payment freeze

  The House of Representatives is expected to vote on February 1 on a final budget package that may...

• JCAHO seeking comments on proposed staff influenza immunization standards

  The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has extended its field...

• Reports find continuing disparities for Hispanics

  Despite modest gains overall in the quality of healthcare for Americans, disparities in care for...

Issue 3, January 18, 2006

• New CMS Web site provides NPI info

  The Centers for Medicare & Medicaid Services' (CMS) new Web site includes a redesigned section...

• Bill would amend Ambulatory Surgical Treatment Center Act

  A bill has been introduced in Illinois to amend the state's Ambulatory Surgical Treatment Center...

• State to celebrate week dedicated to CRNAs

  Pennsylvania will celebrate "Certified Registered Nurse Anesthetists (CRNA) Week" from January...

Issue 2, January 10, 2006

• CMS releases fact sheet on Deficit Reduction Act

  The Centers for Medicare & Medicaid Services (CMS) recently issued a fact sheet detailing the...

• HHS issues industry call to action

  The healthcare industry should assess the proposed standards for electronic healthcare attachments...

• AAASC details effects of congressional cuts to 2007 Medicare ASC payments

  As reported in the December 27, 2005 edition of Ambulatory Surgery Regulatory Update, Congress...

Issue 1, January 3, 2006

• CDC publishes guidelines for preventing TB

  The Centers for Disease Control and Prevention (CDC) has published "Guidelines for Preventing the...

• 2006 PAC/PAS grouper update delayed

  The implementation of the 2006 Products of Ambulatory Care (PAC)/Products of Ambulatory Surgery...

• CMS pushes for bulk enumeration of NPIs

  The Centers for Medicare & Medicaid Services (CMS) is pushing for emergency approval of bulk...