Government Affairs Update


November 7, 2019     Volume IX, Issue 43

 

2020 Final Payment Rule Released; ASCA Rate Calculator Updated to Reflect Changes

CMS Releases CY 2020 MPFS Final Rule

Write to Your Member of Congress Today!

Dr. Hahn Nominated for FDA Commissioner 

2020 Winter Seminar Session Highlight: Patient Record Documentation 101 
 

2020 Final Payment Rule Released; ASCA Rate Calculator Updated to Reflect Changes

As ASCA reported November 1, Medicare has released its 2020 final payment rule for ASCs and hospital outpatient departments (HOPDs). Of note, CMS has finalized its proposal to move eight codes to the ASC-payable list, including total knee arthroplasty (TKA). CMS also finalized the continued alignment of the ASC update factor with that used to update HOPD payments. According to the final rule, CMS plans to use the hospital market basket to update ASC payments for calendar year (CY) 2020 through CY 2023 as the agency assesses this policy’s impact on volume migration. ASCs and HOPDs will receive an effective inflationary update of 2.6 percent for 2020. This increase is based on a projected inflation rate of 3.0 percent minus a 0.4 percentage point productivity adjustment required by the Affordable Care Act.

The 2020 final rule version of the Medicare Rate Calculator, an ASCA members-only resource, is now on our website. As a reminder, for codes not subject to geographic wage index adjustments such as drugs, biologicals, devices with OPPS transitional pass-through payment status and brachytherapy sources, the rate calculator will only display a national payment rate because that is the payment rate regardless of where you are in the country. The separate ‘Calculator With Sequester’ and ‘Calculator Without Sequester’ tabs have been condensed down to one 'Calculator' tab with a dropdown option to apply the reduction for sequestration. The calculator is currently set to apply the reduction for sequestration and can easily be changed to not apply the reduction. We are testing out this change to the rate calculator, so if you have feedback either way, please let us know. More payment resources will be made available on the ASCA website in the coming weeks.

To learn more about the final rule and its impact on your facility, register for ASCA’s webinar “Understanding Medicare’s 2020 Final Payment Rule” on Tuesday, December 3, 2019, at 1:00 pm ET.

For more information, contact Kara Newbury.

CMS Releases CY 2020 MPFS Final Rule

On November 1, the Centers for Medicare & Medicaid Services (CMS) released CY 2020 updates to the Medicare Physician Fee Schedule (MPFS). While the MPFS typically does not affect ASC payments, this year’s rule does contain a provision that will alter the Medicare Conditions for Coverage (CfCs) for ASCs. As first seen in the proposed rule, CMS will change the pre-surgery standards to allow certified registered nurse anesthetists (CRNAs) to perform the pre-surgery anesthesia risk assessment. This change will align the pre-surgery and pre-discharge standards. Taking ASCA comments into account, CMS did clarify that the pre-surgery risk of anesthesia and risk of the procedure to be performed assessments are distinct evaluations, and that only a physician can make determinations regarding the risk of the procedure to be performed. This change becomes effective on January 1, 2020.

Other notable provisions in the 2,475-page final rule include a decision to not apply payment updates to global surgical code packages, against the recommendation of many medical associations. CMS also decided not to finalize a proposal that would have required physicians to notify patients that coinsurance could apply if their screening colonoscopy becomes a diagnostic procedure. You can read a fact sheet and the full rule to learn more.

For more information, contact Alex Taira.

Write to Your Member of Congress Today!

Please act now and request that your member of Congress support your ASC and the patients you serve by cosponsoring H.R. 4350, the Ambulatory Surgical Center Quality and Access Act of 2019. ASCA has made writing to your member of Congress quick and easy using this online customizable form letter.

Your advocacy is critical in getting the attention and support of policymakers.

Contact Adam Parker with any questions.

Dr. Hahn Nominated for FDA Commissioner

On November 1, President Trump announced that Dr. Stephen Hahn, an oncologist and chief medical executive at MD Anderson Cancer Center in Houston, is the administration’s nominee for commissioner of the US Food and Drug Administration (FDA). The role of commissioner has been filled on an interim basis by Ned Sharpless since the departure of Scott Gottlieb in April 2019.

The timeline for Hahn’s confirmation is unclear, as he will likely testify before the US Senate Committee on Health, Education, Labor and Pensions before a confirmation vote. In a concurrent move, US Department of Health & Human Services (HHS) Secretary Alex Azar announced that Assistant Secretary for Health Brett Giroir will lead the FDA until Hahn’s confirmation.

For more information, contact Alex Taira.

2020 Winter Seminar Session Highlight: Patient Record Documentation 101

Appropriate documentation in patient records is an essential component of providing safe, high-quality care. Review the purpose of accurate documentation and explore its importance during the “Patient Record Documentation 101” session offered at the ASCA 2020 Winter Seminar, taking place January 16–18 in New Orleans.

During the session, Debra Stinchcomb, RN, CASC, consultant for Progressive Surgical Solutions, will examine documentation requirements for ASCs, consider legal issues associated with nursing documentation and discuss methods of identifying errors in a patient record.

This session is part of the ASC Management track. The seminar also features two other ASC-specific tracks: Coding & Reimbursement and Finance & Accounting. You can move freely between the tracks and attend any of the sessions offered throughout the seminar. ASCA members receive a discount on each registration and can save even more by signing up two or more people at the same time.

The early bird registration rates for the Winter Seminar end next Friday, November 15, so check out the schedule and register today!