ASCA News Digest (May 24, 2016)

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May 24, 2016

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The New York Times Publishes ASCA’s Letter to the Editor ‘Joan Rivers and Outpatient Surgery’

The New York Times yesterday ran a Letter to the Editor submitted by Bill Prentice, ASCA’s chief executive officer, in response to its article, “Settlement Is Reached in Medical Malpractice Lawsuit Over Rivers’s Death.” In the article, attorneys for Joan Rivers’s family said that there was a lack of oversight at outpatient surgical centers. In his letter, Prentice affirms that ASCs are subject to the same standards of rigorous government oversight and regulation as hospitals.
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Why 503B compounding makes sense?

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ASCA recognized former ASCA and ASCA Foundation Board President Nap Gary with an outstanding service award named in his honor during the opening session of ASCA 2016 last week in Dallas, Texas. The Nap Gary Legacy Award recognizes lifetime service to the ASC community. Gary, who passed away suddenly just days before ASCA 2015, was serving as ASCA’s immediate past president at the time and wanted to have this award in place before moving on.
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Save the date for ASCA 2017, which will take place Wednesday to Saturday, May 3–6, in Washington, DC. Planning has already begun for the meeting and your ideas for session topics and speakers are an invaluable part of determining the exceptional educational content that the meeting provides every year. Topic and speaker submissions for ASCA 2017 will be accepted through July 31, 2016.
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If you attended ASCA 2016 in Dallas, you have until June 30, 2016, 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).
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ASCA Benchmarking subscribers can now access their clinical and operational benchmarking reports for the first quarter (Q1) of 2016. View your Q1 reports by logging into the ASCA Benchmarking portal and clicking on the “Run Reports” tab.

If you are not a subscriber, sign up today to get valuable data about your ASC that you can compare with national performance statistics on clinical outcomes, staff indicators, billing performance and more.
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Industry News


Highmark Affordable Care Act Suit Could Prompt Copycats
Pittsburgh Post-Gazette (05/19/16) Mamula, Kris B.

Highmark could soon be in good company in suing the federal government over Affordable Care Act reimbursement. Other insurers have contacted Highmark since the Pittsburgh carrier filed a lawsuit Tuesday over reimbursement for losses incurred in providing coverage under the ACA, president and CEO David Holmberg said Wednesday.
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Legislation Would Allow for Higher Outpatient, Off-Campus Payment Rates
Healthcare Finance News (05/20/16) Morse, Susan

Bipartisan legislation introduced Wednesday by the leaders of the House Ways and Means Subcommittee on Health resolves two provisions of the Bipartisan Budget Act of 2015 in allowing hospitals that are building outpatient facilities off-campus to be paid at higher reimbursement rates, and in taking into consideration for payment, socioeconomic status. Health Subcommittee Chairman Pat Tiberi, R-Ohio, and Health Subcommittee Ranking Member Jim McDermott, D-Washington, introduced the legislation, H.R. 5273, "The Helping Hospitals Improve Patient Care Act," to address payments to hospitals and other Medicare providers.
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Physicians Endoscopy Collaborating With The Joint Commission and CDC on an Ambulatory Infection Prevention Project
Physicians Endoscopy News Release (05/13/16)

Physicians Endoscopy will be collaborating with The Joint Commission and the Centers for Disease Control and Prevention (CDC) on an initiative designed to adapt, enhance and disseminate CDC guidance related to infection prevention and control in ambulatory health care settings. The goal of this effort, which is supported through a CDC contract, is to create model infection control plans and expand the reach, uptake and adoption of these and other infection prevention and control guidance materials to prevent infections in outpatient settings.
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Surgery Centers Sue No.1 Insurer UnitedHealthcare
Indiana Lawyer (05/18/16) Stafford, Dave

Several Indiana surgery centers are suing the nation's largest health insurance company, claiming it violated state and federal law by failing to pay for services the centers' doctors provided to patients. In a similar lawsuit against the insurer, a key dispute is what the word "pay" means.
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$9.5 Million Settlement Victory for ASCs Approved by Court in Case Filed by Hooper, Lundy & Bookman
Business Wire (05/18/16)

On behalf of out-of-network California Ambulatory Surgery Centers (ASCs), Hooper, Lundy and Bookman, PC, (HLB) is pleased to announce that the court has given final approval for a $9.5 million settlement with United Health Services, ending a class action that was filed over six years ago. The class of around 270 California ASCs alleged that United Healthcare and a number of its corporate subsidiaries, including Optum, Inc. (formerly known as Ingenix) improperly calculated the reasonable and customary amounts for out-of-network ASCs, which resulted in underpayments in the millions of dollars.
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Hospital Safety Rankings May Not Provide Useful Data to Consumers, Study Finds
Baltimore Sun (05/16/16) Cohn, Meredith

Patients who look to publicly available score cards to assess their hospital's safety record may not be getting an accurate picture of the quality of care, according to new research from Johns Hopkins' Armstrong Institute for Patient Safety and Quality. Hospitals have complained for years that the criteria used by U.S. News & World Report, Leapfrog, federal health authorities and others are so varied that results can confuse consumers.
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Task Force Updates Guidelines for Postsurgical Surveillance Colonoscopy, Adding 10 Years of Data
Gastroenterology & Endoscopy News (05/16) Smith, Monica J.

A decade after publishing consensus recommendations for surveillance colonoscopy in patients who have undergone surgical resection for colorectal cancer (CRC), the U.S. Multi-Society Task Force has updated its guidelines to reflect the body of evidence published since 2006. The recommendations, geared specifically toward gastroenterologists, clarify the risks for the recurrence of cancer after resection, advise on the timing of surveillance and address the place of fecal occult blood testing (FOBT) as an alternative to colonoscopy in these patients.
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GE Healthcare and Accenture Target $2 Billion in Lost Revenue Among U.S. Healthcare Providers
Business Wire (05/19/16)

GE Healthcare and Accenture today introduced a new offering to help improve medical claims processing and related cash flow for health care providers. The alliance, targeting medical claims management, one of the largest areas of lost revenue in the U.S. health care system, was announced at GE Healthcare's annual software users conference in Phoenix, where more than 1,500 users are gathered.
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What You Should Know About Hand Hygiene
CDC Safe Healthcare Blog (05/17/16) McDonald, L. Clifford

The science is clear: clean hands can protect patients and health care providers from dangerous and deadly infections. Yet, studies show that on average, health care providers clean their hands less than half of the times they should.
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Improper Medical Billing for DMEPOS Costs Medicare Billions
RevCycle Intelligence (05/18/16) Sampson, Catherine

Medicare continues to lose billions as a result of improper medical billing for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), according to the Council for Medicare Integrity. Specifically, the Medicare program had an improper payment rate of nearly 40 percent in 2015 for DMEPOS.
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