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 federal government affairs news from ASCA:
- Final ACS Rule Update: On November 1, the Centers for Medicare & Medicaid Services (CMS) released its 2025 final payment rule for ASCs and hospital outpatient departments (HOPD). Of note, CMS declined to add any of the surgical procedures requested by ASCA to the ASC Covered Procedures List (ASC-CPL) for 2025. CMS will continue to use the hospital market basket (HMB) as the ASC inflation update factor for 2025, although it is unclear whether that policy will continue further. This results in an effective update of 2.9 percent for ASCs—a combination of a 3.4 percent inflation update based on the HMB and a productivity reduction of 0.5 percentage points mandated by the Affordable Care Act. This is an increase of 0.3 percent from the proposed rule. Please note that this is an average and updates might vary significantly by code and specialty. CMS finalized the addition of 21 procedures to the ASC-CPL, including 19 dental codes that were included in the proposed rule. In addition, the agency finalized the addition of the following two adipose-derived regenerative cell (ADRC) therapy codes (short descriptor in parentheses):
-
- 0717T (Adrc ther prtl rc tear)
- 0718T (Adrc ther prtl rc tear njx)
Regarding the ASC Quality Reporting (ASCQR) Program, CMS is finalizing the adoption of the following measures:
- The Facility Commitment to Health Equity (FCHE) measure beginning with the CY 2025 reporting period/CY 2027 payment determination;
- The Screening for Social Drivers of Health (SDOH) measure beginning with voluntary reporting in the CY 2025 reporting period followed by mandatory reporting beginning with the CY 2026 reporting period/CY 2028 payment determination; and
- The Screen Positive Rate for Social Drivers of Health (SDOH) measure beginning with voluntary reporting in the CY 2025 reporting period followed by mandatory reporting beginning with the CY 2026 reporting period/CY 2028 payment determination.
ASCA will continue to analyze the 1,734-page final rule in detail and provide more information and resources soon, including its proprietary rate calculator, to help ASC operators understand the impact this rule will have on their centers.
- Medicare Physician Fee Schedule Final Rule: On November 1, the Centers for Medicare & Medicaid Services (CMS) released final policy updates for the 2025 Medicare Physician Fee Schedule (MPFS). The rule includes a 2.83 percent reduction to the physician conversion factor, which was expected due to the expiration of a one-year 1.68 percent increase passed as part of the Consolidated Appropriations Act, 2024 (CAA). Physicians have already organized in support of the recently introduced Medicare Patient Access and Practice Stabilization Act of 2024, which would eliminate the forthcoming cut and provide a small inflationary update to physician rates. Congress has had to intervene every year since 2021 to mitigate cuts in the MPFS. ASCA submitted formal comments in response to the MPFS proposed rule, primarily following the advocacy of the specialty societies that work in surgery centers.
- Election Update: Regarding congressional races, Republicans secured a majority in the Senate, winning 53 seats to the Democrats’ 47. The battle for control of the House, which requires 218, has been won by Republicans. Currently, Republicans have 218 seats, while Democrats have 212. Five house races have yet to be called.
-
- ASCAPAC: ASCA’s Political Action Committee (ASCAPAC) contributed to 17 Representatives and Senators in the 118th Congress. All ASCAPAC recipients eligible for reelection in the 118th Congress have successfully won their races, as called by the Associated Press. No PAC-recipient Senators from the 118th Congress were up for reelection this year.
- Federal Legislation: Regarding the cosponsors of H.R.972—Outpatient Surgery Quality and Access Act of 2023—100% of candidates seeking reelection have done so, with the exception of Rep. Miller-Meeks from Iowa’s 1st District, whose race is still pending official results from the Associated Press.