MedPAC makes 1 change to ASC payment report
Centers still may face cuts from Congress
In its March report to Congress, the Medicare Payment Advisory Commission (MedPAC) made one change to its recommendations regarding payment for procedures in ambulatory surgery centers (ASCs). MedPAC says that until the Centers for Medicare & Medicaid Services (CMS) implements a revised ASC payment system, Congress should ensure that payment rates for ASC procedures do not exceed hospital outpatient prospective payment system rates for those procedures after accounting for differences in the bundle of services covered.
"We view this amendment in italics as extremely helpful," said Michael Romansky, JD, partner in the health law department of McDermott, Will, and Emery in Washington, DC, in his advisory for the Johnson City, TN-based American Association of Ambulatory Surgery Centers.
Same-Day Surgery sources point out that hospitals often get paid for other services conducted in association with an outpatient surgery case but billed separately. If Congress embraces a proposal along the lines of the original staff proposal, CMS would be compelled to immediately cut reimbursement for many ASC procedures, he says.
"If Congress adopts the amended recommendation, CMS would be required to first undertake a lengthy and complex analysis to establish an apples-to-apples comparison" of hospital and ASC payments, he says.
However, ASCs may not be in the clear yet, because services and rates are being examined like never before in Washington, Romansky says. Congress still could approve the unamended recommendation it its effort to cut spending to finance a Medicare prescription drug benefit, he reports.
The other MedPAC recommendations in the March report were as expected:
- CMS should expedite the collection of recent ASC charge and cost data for the purpose of analyzing and revising the ASC payment system.
- Congress should eliminate the update to payment rates for ASC services for fiscal year 2004.
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