ASCA News Digest (July 21, 2015)

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July 21, 2015

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ASCA Highlights


Share Your Topic and Speaker Ideas for ASCA 2016

Planning has begun for next year’s annual meeting. Your ideas for session topics and speakers are an invaluable part of determining the exceptional educational content that the meeting provides every year. Submissions for topics and speakers will be accepted through Friday, July 31. All suggestions received after July 31 will be considered for future speaking opportunities. MORE
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ASCA’s free Salary and Benefits Survey will close next Friday, July 31. The survey will not open back up until 2017. Start submitting your data today—the more ASCs that participate, the more valuable the data comparisons will be for your future business planning. The new online platform will produce personalized graphical reports comparing your data with the data of similar ASCs. In order to receive the reports for free, you must answer at least 50% of the questions. MORE
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The data collection period for the second quarter (Q2) of the 2015 ASCA Benchmarking Program will close next Friday, July 31. Start submitting your data today. If you haven't subscribed yet, you can sign up online. Even though you are subscribing during Q2, you will still receive the national/specialty report for Q1. MORE
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Learn about proposed changes to CMS’ ASC payment system for 2016 during ASCA's upcoming webinar on Tuesday, August 4, at 1:00 pm ET. Topics will include Medicare’s method for determining updates to ASC payments for the coming year, whether the agency plans to add any new procedures to the ASC-eligible list and any other policy changes that may impact ASC payments, including changes to the Medicare quality reporting program. MORE
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ASC facilities and providers do not necessarily have to key in each and every ICD-10 diagnosis code, thus creating a master list within its software and billing system. There are certain available data files that might integrate nicely with current billing systems. First, if your ASC has a current EHR system, contact your vendor; your vendor should be able to handle this for you. For facilities and providers working with management companies, this might already be in the works. If your ASC has neither, there are software products available at nominal costs that might meet your needs without endless keying from your end. MORE
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Register for ASCA’s 2015 Fall Seminar, October 8–10, in Louisville, Kentucky. Friday’s concurrent sessions will cover finance and accounting principles, physician credentialing, ICD-10, pharmacy management, QAPI, evaluations and new employee orientation. Thursday and Saturday’s breakout sessions will cover quality reporting, human resources, the Life Safety Code and an AAMI update. The CASC Exam will be offered on Saturday. MORE
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The good news about our private health insurance system is that more Americans have coverage today than at any time in history. The bad news is that private health insurance has, at least historically, perpetuated a system that lacks any real incentives or ability for individuals as health consumers to exercise much discretion over their healthcare purchases. MORE
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ASCA’s Medicare payment resources, including the Medicare Rate Calculator, have been updated to reflect the changes suggested in the proposed rule. These resources are available only to ASCA members. New this year, ASCA has combined all of the payment resources (other than the rate calculator) into one document. This allows members to search for any code that is on the ASC-payable list, and determine several pieces of information about each code. MORE
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The Centers for Medicare & Medicaid Services (CMS) proposed a new payment model for hospitals performing hip and knee replacements in 75 geographic areas throughout the country. Under this model, hospitals would be accountable for the costs and quality of care from the time of the surgery through 90 days post-operation. MORE
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Industry News


'Surgeon Scorecard' Measures Docs by Complications
USA Today (07/14/15) Penzenstadler, Nick

Surgeons around the country are now scored against their peers in a new statistic developed by a non-profit news organization that goes beyond hospital-level data, providing a never-before-available tool for consumers and generating debate and some angst in the surgical community. Nearly 17,000 doctors performing low-risk, common elective procedures such as gallbladder removal and hip replacements are measured in the new calculation, which the non-profit news outlet ProPublica calls an "Adjusted Complication Rate."
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FTC Backs Bill to Reform North Carolina Certificate of Need Laws
Healthcare Finance News (07/17/15) Brino, Anthony

The Federal Trade Commission is throwing its weight behind a bill in North Carolina that would exempt diagnostic centers, ambulatory surgical facilities and psychiatric hospitals from the state's certificate of need law. North Carolina's CON program covers 25 different services, requiring lengthy application and approval processes to expand everything from cardiac catheterization to dialysis centers, and it is one of the most stringent of the 35 health care permitting laws in the country.
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CMS Administrator Slavitt Writes ICD-10 Letter to Providers
RevCycle Intelligence (07/15/15) DiChiara, Jacqueline

The Centers for Medicare & Medicaid Services (CMS) released a letter today addressed to Medicare providers about ICD-10. According to CMS Acting Administrator Andrew M. Slavitt, the health care industry and greater community will thrive in a spirit of cooperation as the upcoming ICD-10 implementation deadline this October approaches.
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Bundling Risk: New Demo Program Shows CMS' Eagerness to Ditch Fee for Service
Modern Healthcare (07/18/15) Evans, Melanie

The deteriorating hips and knees of the nation's seniors were an obvious target for Medicare's first mandatory test of an alternative payment model for hospitals. But joint replacement is not the only possible target, and hospitals are now on notice that Medicare will move ahead if they don't do it on their own.
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N.Y. Law Offers Model For Helping Consumers Avoid Surprise Out-Of-Network Charges
Kaiser Health News (07/14/15) Andrews, Michelle

It's a situation that occurs all too often: Someone goes to the emergency room and doesn't learn until he gets a hefty bill that one of the doctors who treated him wasn't in his insurance network. Or a diligent consumer checks before scheduling surgery to make sure that the hospital she plans to use and the doctors that will perform it are all in network.
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CMS Soliciting Comments on Office-Based Cataract Surgery
Outpatient Ophthalmic Surgery Society (07/09/15)

In its proposed 2016 Medicare fee schedule regulation issued yesterday, CMS is soliciting information from interested stakeholders regarding the advisability of paying for cataract surgery in the office-based surgical suite. CMS cites a number of perceived advantages in implementing such a policy: advancements in technology; patient convenience; flexibility in scheduling surgery; and, lower Medicare expenditures, to name a few.
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Most US Physicians Still Work in Small Practices
Medscape (07/13/15) Brooks, Megan

Most physicians in the United States continue to work in small practices despite the challenging health care working environment, according to an updated Policy Research Perspectives from the American Medical Association (AMA). "These data show that the majority (60.7%) of physicians were in small practices of 10 or fewer physicians, and that practice size changed very little between 2012 and 2014 in the face of profound structural reforms to health care delivery," AMA president-elect Andrew W. Gurman, MD, says in a news release.
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CMS Cutting-Edge Technology Identifies & Prevents $820 Million in Improper Medicare Payments in First Three Years
CMS Press Release (07/14/15)

After three years of operations, the Centers for Medicare & Medicaid Services (CMS) today reported that the agency's advanced analytics system, called the Fraud Prevention System, identified or prevented $820 million in inappropriate payments in the program's first three years. The Fraud Prevention System uses predictive analytics to identify troublesome billing patterns and outlier claims for action, similar to systems used by credit card companies.
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Do Cellphones Belong in the Operating Room?
Washington Post (07/13/15) Luthra, Shefali

Next time you're on the operating table and you take one last look around as the anesthesiologist approaches, don't be too sure that that person in scrubs looking at a smartphone is pulling up vital health data. He or she might be texting a friend, or ordering new carpet.
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Federal Health Exchange Approved Fake Claims
Wall Street Journal (07/15/15) Armour, Stephanie

The federal exchange set up under the Affordable Care Act allowed fictitious applicants to maintain coverage and re-enroll this year, according to a report by a congressional watchdog group that raises questions about the marketplace's ability to detect fraud. The exchange, HealthCare.gov, last year approved 11 fictitious applications submitted in an undercover operation by the Government Accountability Office, according to the report released Wednesday by the agency.
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Surgery Center Would Cut Costs
Rutland Herald (VT) (07/15/15) Gunther, Peter

Recently, a group of local physicians filed a certificate of need application with the Green Mountain Care Board requesting approval to open an independent outpatient surgery center in Colchester. National data show that the costs of procedures at such community-based centers are 45-60 percent less than in a hospital setting.
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