Federal Government Affairs News and Notes:

Friday, September 30, 2022 11:33 AM | WiSCA (Administrator)

WISCA works closely with our national association partner – the Ambulatory Surgery Center Association (ASCA) – on advocacy and other issues important to our members. In fact, the WISCA Government Affairs Team joins a national ASCA state chapter call twice a month for a federal regulatory and legislative briefing and closely follows their published Government Affairs Updates. Here is the latest government affairs news from ASCA:

  • ASCA Submits Comments on 2023 Proposed Payment Rule
  • On September 13, ASCA submitted formal comments (attached) in response to the Centers for Medicare & Medicaid Services’ (CMS) CY 2023 OPPS/ASC proposed payment rule. Some of ASCA’s key comments are below:
  • Update Factor. CMS should use the hospital market basket as the annual update mechanism for ASC payments indefinitely. The agency should extend the five-year trial given that Medicare volume data has been skewed the past two years due to the COVID-19 pandemic.
  • ASC Weight Scalar Adjustment. CMS must discontinue the ASC weight scalar. With the 2019 change in the update factor, it is even clearer that removing this secondary scaling adjustment is necessary to truly align the payment systems and enable ASCs to capture the value of the conversion factor, which will motivate increased migration of surgery to the ASC setting and lower the cost of care.
  • Procedures Permitted in ASCs. CMS should add the codes ASC clinicians have requested for addition to the ASC-CPL for 2023 or explain why the agency chooses not to allow surgeons to perform these procedures in the ASC setting.
  • Complexity Adjustment. CMS should finalize its proposal to provide complexity adjustments for combinations of certain service codes and add-on procedure codes that are eligible for a complexity adjustment under the OPPS.
  • Quality Reporting. CMS should finalize its proposal to suspend mandatory implementation of ASC-11 as it is a little-used clinical measure that will create an undue burden for facilities.
  • ASCA expects the final payment rule to be released on or before November 2. Contact Kara Newbury with any questions.
  • State ASC Associations Support ASCA’s Comments on 2023 Proposed Payment Rule

On September 13, ASCA submitted a state ASC association sign-on letter in response to the Centers for Medicare & Medicaid Services’ (CMS) CY 2023 OPPS/ASC proposed payment rule. The letter was created to allow state ASC associations to easily show support for ASCA’s comments and had support from ASC associations across the country. Wisconsin and WISCA signed-on to the letter, joining 31 other states.

  • Extraordinary Circumstances Exceptions for ASC-20

ASCA has heard from members who were unable to submit ASC-20: COVID-19 Vaccination Coverage Among Health Care Personnel data by the first quarterly deadline on August 15. In the event that your ASC was unable to submit any required information due to an extraordinary circumstance, your ASC may request an exception. To request an exception, you must submit a completed Extraordinary Circumstances Exceptions form with any required information and supporting documentation within 90 calendar days of the missed deadline. For all ASCs subject to this reporting requirement, please remember that the next quarterly deadline is November 15.

  • Legislation Introduced to Prevent Physician Fee Cut

On September 13, the Supporting Medicare Providers Act of 2022 (H.R. 8800) was introduced by Representatives Ami Bera, MD (D-CA), and Larry Bucshon, MD (R-IN). The legislation would provide an additional 4.42 percent to the physician conversion factor (CF) for 2023. As a reminder, in the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) proposed a 4.4 percent cut to the 2023 CF, mostly due to the expiration of a temporary, one-year 3 percent increase to the CF passed as part of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) in December 2021. ASCA is part of a coalition of provider organizations supporting such efforts and expects that a coalition letter will be sent on this specific legislation in the near future. Most recently, the coalition sent a letter asking Congress for relief from impending physician payment cuts. The letter asked Congress to approve at least a 4.5 percent increase in the 2023 physician CF and to waive a 4 percent statutory PAYGO cut.

Association of Wisconsin Surgery Centers
563 Carter Court, Suite B Kimberly WI 54136
920-560-5627 I WISCA@badgerbay.co

Powered by Wild Apricot Membership Software