ASCA News Digest (November 18, 2014)

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November 18, 2014





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ASCA Highlights


Registration Now Open for ASCA 2015

Registration is now open for ASCA 2015, May 13–16, 2015, in Orlando, Florida. Register today to take advantage of early bird discounts. ASCA members can enjoy additional savings by sending more than one attendee. ASCA 2015 will offer more than 60 educational sessions and networking opportunities to exchange best practices and discuss marketplace trends that could have immediate and long-term implications for your ASC. MORE
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ASCA's 2015 Final Medicare Rate Calculator is now available. The members-only resource shows your national and local payment rates for 2015. Simply look up your local wage index from the easy-to-use chart and type it into the calculator and the calculator does the rest. ASCA's other Medicare payment resources will be updated soon. MORE
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Earn continuing education (CE) credit with ASCA's new Regulatory Training Series. The 21 interactive courses specifically apply to ASCs and will help orient new staff, assess competency and assist in meeting regulatory and accreditation standards. Take advantage of special introductory pricing through January 31, 2015. MORE
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Register for ASCA’s 2015 Winter Coding Seminar, January 22-24, 2015, in San Diego, California. This comprehensive program will cover coding tips for commonly performed ASC procedures, assessing coding accuracy and productivity, CPT changes that will take effect in 2015, ICD-10 and more. Attendees will be awarded up to 19.5 CEU(s) from AAPC. MORE
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When embezzlement occurs in an ASC, the center typically suffers a direct financial loss—money that should have been available for purchasing supplies and services is diverted. And that's just the beginning. Learn how embezzlement occurs, possible indicators, preventing embezzlement and how to respond. MORE
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Plan now to attend ASCA’s Medical Director Leadership Seminar, May 16-17, 2015, in Orlando. This premier seminar will address high-level aspects of issues surrounding ASC management, expectations and responsibilities. Participants will come together to examine current challenges and selected clinical concepts in ambulatory surgery. Join with ASC medical directors and physician leaders from across the country for this exclusive opportunity. MORE
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If you attended ASCA's 2014 Fall Seminar in Scottsdale, you have until next Friday, November 30, to submit your continuing education credits online. To submit online, you will need your ID number located on the back of your attendee badge. (If you no longer have your badge, you can request your ID number by sending an email to registration@ascassociation.org.) MORE
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As previously announced, the Centers for Medicare & Medicaid Services (CMS) released its final 2015 ASC payment rule on October 31, 2014. There were a few changes to the quality reporting program in Medicare's final rule that centers should be aware of for next year. MORE
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Industry News


CMS Says Now Is Time to Prepare for ICD-10
Health Data Management (11/06/2014) Slabodkin, Greg

With less than a year until the ICD-10 compliance deadline of Oct. 1, 2015, health care organizations should be using the time to prepare for the code switchover, says the Centers for Medicare and Medicaid Services (CMS). Speaking at a Nov. 5 Medicare Learning Network webinar, Stacey Shagena with the CMS Medicare Contractor Management Group said that there will be end-to-end testing in January, April, and July 2015 with Medicare Administrative Contractors, the Railroad Retirement Board, and the Common Electronic Data Interchange contractor. About 850 health care providers will have the chance to participate in each testing period. The testing is meant to demonstrate that health care organizations can successfully submit ICD–10 claims to shared systems and that software changes lead to appropriately adjudicated claims.
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Obamacare 2015 Sign-Up Under Way With Few Glitches
Bloomberg (11/15/14) Wayne, Alex; Barker, Dalton

Secretary of Health and Human Services Sylvia Mathews Burwell says 100,000 people submitted new applications for Obamacare in the first days of the second open enrollment period. In addition to new applicants, 500,000 customers were able to log on to HealthCare.gov, and 1 million people have gone "window shopping" to compare insurance plans and prices over the past week. The Obama administration is working to add an additional 3 million or more people to the 7.1 million already enrolled in plans established by the 2010 Patient Protection and Affordable Care Act. The enrollment period ends Feb. 15.
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New Variant of Health-Care 'Skinny' Plans Draws Regulator Scrutiny
Wall Street Journal (11/04/14) Mathews, Anna Wilde

The U.S. Treasury and the U.S. Department of Health and Human Services issued a notice on Nov. 4 indicating that health plans that do not "provide substantial coverage for in-patient hospitalization services or for physician services" do not meet the Affordable Care Act's standard for minimum value. As a result, employers offering these so-called "skinny plans" that cover preventive care but little else could be hit with a penalty for failing to provide adequate coverage and another penalty for workers who turn down the employer-provided plan and obtain subsidized coverage through an exchange. Employers who officially signed up for such a plan prior to Nov. 4 will not be subject to the penalties for the first year if their plans kick in before March 1, 2015, but their employees may still qualify for subsidies.
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Hospitals Take Cues From the Hospitality Industry
Kaiser Health News (11/04/14) Rabin, Roni Caryn

Hospitals have begun to hire a new kind of executive, one who focuses on patient satisfaction and makes sure staff attends to patients' needs. The new position, the chief patient experience officer, has developed since the Affordable Care Act, which imposes penalties based on a hospital's ranking relative to other hospitals. Chief patient experience officers examine patient satisfaction survey results and attempt to make changes through teamwork, innovation, and a philosophy of compassion and respect. Some experts remain concerned that the facilities that provide the best care do not always get the best patient feedback, but research suggests there is a significant correlation between higher patient satisfaction and better treatment outcomes.
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Nurse Practitioners, Physician Assistants Fill in Primary Care Gaps
Buffalo News -- (11/07/14) Scanlon, Scott

Experts say the growing presence of nurse practitioners (NPs) is spurring changes in medical practices. In the state of New York, a law taking effect in 2015 will allow NPs to more easily start their own primary care practices, including businesses where patients are treated at home or online. Many physicians and doctor groups rely on NPs and physician assistants (PAs) to handle disease management and preventative care. NPs are governed by a state nursing board, while PAs are licensed by a state medical board. As a result, the majority of nurse practitioners work in primary care settings, while physician assistants tend to be employed across various specialties. Advanced care providers often are typically allowed to performing physical exams, order and interpret diagnostic tests, prescribe medications, assist in the operating or emergency room, and perform certain procedures and surgeries.
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CMS to Pay Docs for Care Coordination, Telehealth
Modern Healthcare (10/31/14) Evans, Melanie

The Centers for Medicare and Medicaid Services (CMS) on Oct. 31 issued final rules that contain changes to Medicare payments for doctors, a revision of the Sunshine Act's reporting requirements and new quality criteria for the Medicare Shared Savings Program, among other things. One of the rules calls for Medicare payments to doctors to be cut by 21.1 percent beginning April 1 under the sustainable growth rate formula. In addition, the rules call for Medicare payments to physicians to be adjusted by quality performance under value-based payment modifiers beginning next year. Thirty-three new quality criteria for the Medicare Shared Savings Program, a test of the accountable care payment and delivery model, were included in the rules. Finally, the rules ended the Sunshine Act's exemption for payments to physicians associated with accredited continuing medical education.
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Surgeons Buy Into Outpatient Facility
Glendale News Press (CA) (11/12/14) Mikailian, Arin

When the outpatient surgery facility at Glendale Adventist Medical Center in Glendale, Calif., recently reopened, physicians were allowed for the first time to buy a stake in the facility. Dubbed the Physicians Adventist Surgery Center, the upgraded ambulatory surgery center now offers ophthalmology and minimally invasive spine surgeries in addition to orthopedic and podiatry services, according to Christine Pierce, business operations manager of the facility. ASD Management was hired to oversee the day-to-day operations of the renamed surgery center. "The physicians didn't want to be the sole manager and the hospital doesn't need to be the sole manager, so they brought in a third-party management company [which] has all the years of experience of running this kind of joint venture," Pierce explains. The 15,000-square-foot facility has a patient-and-family reception area along with four surgical suites, one general procedure room, and two private recovery rooms.
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Survey: Most Large Healthcare Providers Ready for ICD-10 Testing
Journal of AHIMA (11/04/14) Dimick, Chris

A new survey by eHealth Initiative (eHI) and the American Health Information Management Association (AHIMA) reveals that more health care executives are aware of the long-term benefits of using ICD-10-CM/PCS compared to a year ago. In addition, the majority of respondents working in larger health care organizations said they are far enough along in their implementation process to conduct end-to-end testing on ICD-10 before the Oct. 1, 2015, deadline. However, smaller organizations said they are less equipped to test. Most respondents also said the new code set would likely make managing population health and conducting clinical, health services, or translational research easier. Organizations said they intend to leverage the increased specificity of the code set for claims processing and billing, quality improvement, performance measurement, and outcome measurement. AHIMA and eHI recommend that providers test early and frequently and during all stages of implementation.
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Dispute Imperils Hospital Coverage
Sarasota Herald-Tribune (FL) (11/11/14) Clark, Maggie

United Healthcare Medicare Advantage is issuing letters to its policyholders stating that on Dec. 31, Sarasota Memorial Hospital in Sarasota, Fla., may no longer be an in-network provider for the insurer. If so, consumers and patient would have to pay out-of-network rates at Sarasota Memorial, its urgent care centers, and outpatient surgery centers. Meanwhile, Sarasota Memorial has filed a lawsuit against United Healthcare on the grounds that the insurer is illegally terminating its contract. Only Medicare Advantage members who have visited Sarasota Memorial in the past year will receive letters about the issue from United Healthcare, while the insurer's other policyholders in Sarasota County will receive letters in the coming weeks if the dispute is not resolved.
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Northwest Michigan Surgery Center Largest of Kind in Michigan
MyNorth.com (MI) (11/12/2014) Bingham, Emily

The 42,000-square-foot Northwest Michigan Surgery Center, based in Traverse City, Mich., is the largest outpatient surgery center in the state. The surgery center serves 19,000 patients annually, staffed by 73 board-certified procedural physicians, 21 certified registered nurse anesthetists, 40 anesthesiologists, and more than 120 other health care personnel. Patients generally pay 30 percent to 40 percent less at the center than they would for the same procedure performed at a hospital. In addition, Northwest Michigan Surgery Center donates services to those in need, last year totaling $200,000 in Medicaid and charity care. The center's board of physician-owners acts as a team when deciding when and how to incorporate new procedures and technology. Recent advancements at the center include new endoscopes and colonoscopes and a laser that can perform fine incisions and correct astigmatism during cataract surgery.
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