ASCA News Digest (July 12, 2016)

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July 12, 2016

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ASCA Highlights


CMS Releases 2017 Proposed Payment Rule for ASCs

The Centers for Medicare & Medicaid Services (CMS) released the 2017 proposed payment rule for ASCs and hospital outpatient departments last week. If the proposed rule were to be finalized as drafted, ASCs would see an effective update of 1.2 percent—a combination of a 1.7 percent inflation update based on CMS's estimation of the change in Consumer Price Index for All Urban Consumers and a productivity reduction mandated by the Affordable Care Act of 0.5 percentage points.
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AW0380-PolicyStat Product Showcase   PolicyStat Makes Surveys Easy and Pain Free


PolicyStat is policy management software that gets your staff the information they need when they need it. You're too busy to spend time searching for the most up to date policies and procedures. Stop searching and get consistently positive survey results with PolicyStat. Learn More


ASCA recently added "The Importance of Hand Hygiene Compliance," "Latex Allergy" and "Prevention of Healthcare-Associated Influenza in Ambulatory Care" to its library of Regulatory Training Series courses. Use the new “Purchase Now” button on the web site to sign up and begin earning CE credit right from your computer.
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The data collection period for the second quarter (Q2) of the 2016 ASCA Benchmarking Program is now open and will close on July 31. Those who subscribe and submit their data before the second quarter ends will have a more complete picture of their ASC’s performance by the end of the year. ASCA Benchmarking features significant improvements for the 2016 program, including dynamic filtering, real-time data review and a streamlined, easy-to-complete survey design.
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As health care organizations continue to compete on multiple levels, ASCs need to set themselves apart or risk losing to other players in the field. Visit the ASC Focus magazine web site for strategies to help position your ASC as the facility of choice for physicians, staff and patients.
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Let us know what you would like to see at ASCA 2017, May 3–6, in Washington, DC. Your ideas for session topics and speakers help us determine what educational content will be most meaningful to attendees. Topic and speaker submissions for ASCA 2017 will be accepted through July 31, 2016.
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4.1 PharMEDium  

Why 503B compounding makes sense?

PharMEDium is the leading provider of pharmacy-outsourced, ready to use compounded sterile preparations.  PharMEDium helps to:  mitigate medication supply issues, enhance patient safety efforts, reduce drug waste and simplify regulatory compliance.  PharMEDium, part of AmerisourceBergen, serves 3,000+ hospitals and ambulatory surgery centers through our state-of-the-art FDA Registered 503B Outsourcing Facilities.


In the 2017 proposed payment rule, the Centers for Medicare & Medicaid Services (CMS) proposed to add five measures based on the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) survey, to the ASC Quality Reporting Program beginning with 2020 payment determinations. ASCA is asking its members to complete a three-question survey regarding their current participation in OAS CAHPS, or interest in participating.

In order for ASCA to advocate effectively for the interests of our members, we would greatly appreciate if you could fill out a quick three-question survey regarding your current participation in OAS CAHPS, or interest in participating.
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Industry News


Justice Department to Make $40 Million Available for Victims of Deadly Meningitis Outbreak
Washington Post (07/07/16) Zapotosky, Matt

The Justice Department plans to make as much as $40 million available for victims of a 2012 fungal meningitis outbreak that federal investigators traced to a batch of contaminated steroid injections after a dispute over whether those affected by the outbreak qualified for such financial assistance was finally resolved, officials said. While some of the details still need to be worked out, the Office for Victims of Crime has decided to make the money available from its Crime Victims Fund, which is financed by fines and penalties paid by those convicted of crimes, the officials said.
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Aetna Meets With Justice Department Over Merger With Humana
Reuters (07/09/16) Humer, Caroline; Bartz, Diane

Aetna Inc executives met with top Justice Department antitrust officials on Friday to convince the government that asset sales it proposed would address potential competitive problems that could threaten its deal to buy rival Humana Inc, according to a source familiar with the matter. Aetna's plan to buy Humana would combine two of the largest providers of Medicare Advantage plans for elderly people, and investors are concerned that antitrust regulators could oppose the deal.
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UnitedHealth Fight Highlights Third-Party Payment Question
Healthcare Dive (07/06/16) Caspi, Heather

UnitedHealth Group has filed suit against dialysis provider American Renal Associates Holdings Inc., alleging fraud over its efforts to help consumers cover premiums for private health policies, The Wall Street Journal reported. The insurer argued ARA schemed to get patients who were eligible for Medicare or Medicaid to instead sign up with UnitedHealth and use charity money to cover the premiums, all so ARA could file for UnitedHealth's larger reimbursements.
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Surgical Center Sues DHL Over Billing
Houston Chronicle (07/05/16) Sixel, L.M.

A health care provider in Richmond has sued DHL Express in federal court in Houston, alleging that the giant delivery company teamed up with its insurance company to wrongfully deny and underpay medical benefits for plan members. The Center for Advanced Surgical Treatment, a surgical center that operates outside of established insurance networks, accuses DHL, along with its parent company, DPWN Holdings, a German-owned company with its U.S. headquarters in Florida, of setting up a compensation structure that rewards Cigna for rejecting claims for medical care and pocketing the money it saves the plan, according to the lawsuit filed last week.
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Study Finds Preoperative Falls Common Among Adults of All Age Groups
News-Medical.net (07/04/2016)

In a large study of 15,000 adults undergoing elective surgery, researchers at Washington University School of Medicine in St. Louis found that falling up to six months before an operation is common and often causes serious injuries--not only in elderly patients but across all age groups. Surprisingly, the frequency of falls among middle-aged patients was slightly higher than those who were age 65 or older.
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New Checklist to Make Health Estimates More Transparent, Accurate and Reliable
WHO News Release (06/28/16)

American author Mark Twain was fond of saying that there are 3 kinds of lies: lies, damned lies and statistics. To which WHO Director-General Dr Margaret Chan would respond, "What gets measured gets done."
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Total Hip Replacement: In and Out in a Day
KOLOTV.com (Nevada) (06/27/16) Johns, Sarah

Reno resident Dave Fish is pretty rough on his body. As the owner of Eclipse Pizza, he's on his feet all day.
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AMSURG Employees Make A Wish Come True
AmSurg (07/08/16)

More than one hundred AMSURG employees cheered as Make-A-Wish Middle Tennessee recipient Fiona arrived at the Nashville corporate office amid a chocolate-themed celebration. From April to June, employees contributed to fulfill Fiona's wish of visiting Disneyland with her family, an effort that culminated in the reveal party on Thursday, June 23.
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Inaccurate Provider Lists a Major Barrier to Care, Study Finds
Kaiser Health News (07/08/16) Bazar, Emily

Provider directories for some health plans sold through Covered California and in the private market are so inaccurate that they create an "awful" situation for consumers trying to find doctors, according to the lead author of a new study published in the journal Health Affairs. In the study, "secret shoppers" posing as patients were able to schedule an appointment with a primary care physician less than 30 percent of the time.
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Medicare Proposes Substantial Improvements to Paying for Care Coordination and Planning, Primary Care, and Mental Health in Doctor Payment Rule
CMS Press Release (07/07/16)

Today, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Physician Fee Schedule to transform how Medicare pays for primary care through a new focus on care management and behavioral health designed to recognize the importance of the primary care work physicians perform. The rule also proposes policies to expand the Diabetes Prevention Program within Medicare starting January 1, 2018.
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Primary Care Visits Result in More Colon Cancer Screening, Better Followups
Science Daily (06/24/2016)

People who visit their primary care physicians are more likely to get potentially life-saving colon cancer screenings and follow up on abnormal stool blood test results--even in health systems that heavily promote mail-in home stool blood tests that don't require a doctor visit, a study involving UT Southwestern population health researchers shows. The results are important because screening for colon cancer--the third most common cancer and the second leading cause of cancer deaths in the United States--is underutilized in the U.S.
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CMS Proposes Hospital Outpatient Prospective Payment System Changes to Better Support Physicians and Improve Patient Care
CMS Press Release (07/06/16)

Today, the Centers for Medicare and Medicaid Services (CMS) proposed updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Several of the proposed policy changes would improve the quality of care Medicare patients receive by better supporting their physicians and other health care providers.
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