ASCA News Digest (September 30, 2014)

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September 30, 2014





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ASCA Highlights


Free HIPAA Resources for ASCA Members

As of Monday, September 22, 2014, all business associate agreements must comply with changes that were made in the 2009 HITECH Act and the January 25, 2013, final HIPAA Omnibus Rule. ASCA has posted a Sample Business Associate Policy and Sample Business Associate Agreement Provisions, which takes the sample language available on the HHS web site and provides commentary that may help ASCs craft their agreements. MORE
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CMS has released its October addenda, which provides fourth quarter updates to the ASC payment system. ASCA’s payment resources have been updated to incorporate the October addenda changes, including the Fourth Quarter Ancillary Rates document and the 2014 ASC List Changes document. MORE
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Data collection for ASC-8: Influenza Vaccination Coverage among Healthcare Personnel will be reported in 2015 for Medicare’s ASC Quality Reporting Program through the National Healthcare Safety Network (NHSN). To report ASC-8 through NHSN as required, someone from your ASC must register with NHSN. This registration process can take several weeks, so ASCs are advised to register immediately. MORE
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Ensure that your ASC is prepared for 2015’s coding and billing changes by registering for ASCA’s 2015 Winter Coding Seminar, January 22-24, in San Diego. This comprehensive program is a "must" when it comes to learning best coding practices that assure you receive the reimbursements you deserve. Sessions 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. MORE
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The data collection period for the third quarter (Q3) of the 2014 ASCA Benchmarking Program will open tomorrow, October 1. Subscribers will receive an email alerting them when they can begin to submit data. The collection period will close October 31. If you haven’t purchased your 2014 subscription yet, there is still time to sign up. MORE
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An ASC's governing board is ultimately responsible for all operations of the center. Since boards typically meet every other month or quarterly, one must determine how to get the board information in an easy, concise manner. That is where key performance indicators (KPIs) are imperative. They allow the board to see how well the facility is performing but does not require them to analyze pages and pages of data. MORE
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During the week of January 26 through 30, 2015, a sample group of providers will have the opportunity to participate in ICD-10 end-to-end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. Additional opportunities for end-to-end testing will be available in 2015. Any issues identified during testing will be addressed prior to ICD-10 implementation. MORE
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ASCA submitted a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner last week requesting that CMS more fully utilize the mechanisms in place to promote the development of innovative medical advancements for the ASC setting. MORE
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Industry News


Spotlight to Shine on Physician Payments
Modern Healthcare (09/27/14) Lee, Jaimy

The federal government is slated to launch its Open Payments website on September 30. However, there are questions about who will use the data on the site, which is required by the Physician Payments Sunshine Act, and how. The Sunshine Act aims to help patients understand possible conflicts of interest, but some experts suggest the information could be used, for example, by government investigators and insurers monitoring doctors' practice patterns. "Anyone who is paying for medical services of various types is going to be interested in this," said Dan Kracov, a partner with law firm Arnold & Porter. Meanwhile, a new national group, called Who's My Doctor?, is encouraging physicians to disclose their financial relationships with medical manufacturers but also other details of their professional finances, such as if they are given fee-for-service payments that could lead them to perform more services.
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AAAASF Addresses Patient Safety in Outpatient Facilities
American Association for Accreditation of Ambulatory Surgery Facilities (09/23/2014)

The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) says that the ambulatory surgery arena has a sterling track record for safety and professionalism. The organization has maintained since 1999 a database on adverse events occurring in the facilities it certifies. More than 12 million operations have been performed in those facilities since then, with a mortality rate of about one in 50,000 procedures. Many of these are due to pulmonary embolisms, which are a risk with any form of surgery. AAAASF also finds low infection rates of one in 2,400 procedures at facilities it certifies. Said Dr. Geoffrey Keyes, AAAASF board president, "Safety is our primary concern in delivery of outpatient surgical care. We constantly assess surgery center performance through the inspection process and Internet submitted data from our facilities to show outpatient facilities are safe and convenient for patients of all ages."
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SC House Panel Begins Review of Certificate-of-Need Program
The State (SC) (09/24/14) Cope, Cassie

A panel of South Carolina state representatives is reviewing the state's certificate-of-need program, which approves or rejects requests for new or expanded medical facilities. Under the program, health care facilities must prove that the new or expanded services are necessary in their area. Last year, Gov. Nikki Haley vetoed money that the Department of Health and Environmental Control used to process certificate-of-need applications, causing the program to be suspended and allowing some medical companies to build or expand without the certificates. Since the state Supreme Court ruled that the department could not suspend the program, the House will recommend how to reform the certificate-of-need program and address the companies that expanded while it was dormant. One option would be to do away with the certificate-of-need program, but supporters say that it saves money by keeping unnecessary medical services from being duplicated.
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HealthCare.gov Is Given an Overhaul
New York Times (09/23/14) P. A18 Pear, Robert

The Obama Administration announced on Sept. 22 that HealthCare.gov will be redesigned, with a shorter, simpler online application available to 70 percent of consumers to purchase health coverage during the second annual open enrollment period that begins in mid-November. The shorter application--which has fewer pages and questions and fewer screens to navigate--can be used only by first-time applicants with uncomplicated household situations. The new application also features backward navigation, allowing consumers to change information input on previous screens. Consumers will be asked screening questions to determine whether they can use the new application.
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Health-Law Coverage Expansion Gets Tougher
Wall Street Journal (09/29/14) P. A4 Armour, Stephanie; Radnofsky, Louise

For the second open enrollment period under the Affordable Care Act, which begins Nov. 15, the Obama Administration, states, and insurers aim to enroll millions of new enrollees and ensure that existing customers keep their plans for 2015. Letters will be mailed as soon as next month to around 5 million people who obtained coverage through HealthCare.gov, informing them that their plans will automatically be renewed but that they can revisit the site to change their coverage, and letters from their insurers will explain their premiums for next year. Meanwhile, states operating their own exchanges will send emails and letters to enrollees detailing what they must do to re-enroll for 2015. Pent-up demand for coverage prompted millions to enroll last year, but advocates must now undertake new outreach efforts targeting new enrollees.
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After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn't Know
New York Times (09/21/14) P. A1 Rosenthal, Elisabeth

Physicians and other health providers often collaborate when providing patient care, but it has become increasingly common for assistants, consultants, and other hospital employees to charge patients or their insurers significant fees in a practice dubbed "drive-by doctoring." Whether their services were needed is questionable, and patients may not even realize these providers were involved in their care until they receive the bill. Several state insurance commissioners have attempted to limit patients' liability when it comes to unexpected out-of-network charges, but they say their efforts have been stymied by lobbying from the health care industry.
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Is Physician Work in Procedure and Test Codes More Highly Valued Than That in Evaluation and Management Codes?
Annals of Surgery (09/14) Kerber, Kevin A.; Raphaelson, Marc; Barkley, Gregory L.; et al.

A recent study attempted to determine whether the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule ascribes higher value for physician work in procedure and test codes than in Evaluation and Management (E/M) codes. For the study, the researchers looked at data for relative value units (RVUs), physician work times in minutes, and claims for all active level I Current Procedural Terminology (CPT) codes from 2011 CMS files. The research showed, however, that in comparison with E/M codes, procedure/test codes had no significant difference in work RVUs adjusting for time, nor was a work RVU advantage specifically signaled for Surgical CPT codes versus E/M adjusting for time.
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Google Glass Makes Doctors Better Surgeons, Stanford Study Shows
VentureBeat (09/16/14) Sullivan, Mark

New research from Stanford Medical School and VitalMedicals suggests that surgeons using Google Glass during their procedures performed better. In the small study, Stanford residents performed two kinds of surgeries using dummies, one while using Google Glass and one without. In the test involving a bronchoscopy, residents using the real-time vitals app made by VitalMedicals identified critical desaturation 8.8 seconds faster than the control group. For the second test, in which the dummy patient required a thoracostomy tube placement through the chest wall, residents using the app recognized hypotension in the patient 10.5 seconds faster than the control group. In addition, residents using Google Glass looked at the monitoring equipment much less during surgery, which helped them to stay more focused on the patient.
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