ASCA News Digest (September 20, 2016)

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September 20, 2016

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CMS Releases Final Rule on Emergency Preparedness

The Centers for Medicare & Medicaid Services (CMS) has released the final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. This final rule establishes national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to plan for both natural and man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency preparedness systems.
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PolicyStat Banner

The reputation of your ASC depends on its ability to comply with constantly evolving laws and regulations. Attend ASCA's Minimizing Your Regulatory and Legal Risk seminar in San Antonio, Texas, January 12–14, 2017, and learn how to navigate the complex legal and regulatory hurdles that your center will face in the coming year so that you can focus on delivering the best patient care.

Register now for ASCA’s Minimizing Your Regulatory and Legal Risk Seminar and receive an early registration discount!
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California Ambulatory Surgery Center Association (CASA) announced the inaugural recipients of the CASA Award for ASC Excellence and the CASA ASC of the Year last week, according to the CASA web site. Visit the “Name in the News” section of the ASC Focus web site to read about the winners.
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Anterior cervical discectomy and fusion (ACDF) surgeries can be performed in the ASC environment with equivalent safety compared with safety in the inpatient hospital setting, says Anthony L. Asher, MD, ASCA Board member. Read about tips on patient selection and tracking metrics to fit ACDF in the ASC setting in the bundled care model on the ASC Focus web site.
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Two days before Thanksgiving in 2013, a family member of a patient at Good Shepard Ambulatory Surgical Center entered the center and stabbed five people. The community around the center reeled from the incident, but eventually Good Shepard Ambulatory Surgical Center learned from it and became stronger.

Join ASCA’s next webinar to hear Beth Chrismer, RN, MSN, Good Shepard’s risk manager and a first responder at the incident share her experience and lessons learned to help you prepare for and avoid an incident of this kind in your ASC. This program will take place Tuesday, September 27 at 1:00 pm ET.
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AW0380-PolicyStat Product Showcase  

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The Centers for Medicare & Medicaid Services (CMS) is providing facilities with Claims Detail Reports (CDRs) for measure ASC-12 (Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy) via the QualityNet Secure Portal beginning September 6, 2016. Additional information on CDRs can be found by selecting the “Claims Detail Reports” page on QualityNet. The CDR contains patient-level data for this colonoscopy measure. CMS encourages facilities to review their CDRs thoroughly.
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Industry News


Delivering Coordinated, High Quality Care for Patients
CMS Blog (09/19/16) Conway, Patrick

In July 2016, CMS proposed new bundled payment models that continue the Administration's progress to shift Medicare payments from rewarding quantity to rewarding quality by creating strong incentives for hospitals and clinicians to deliver better care to patients at a lower cost. These proposed new bundled payment models focus on heart attacks, heart bypass surgery, and hip fracture surgery.
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Surgical Care Affiliates Partners With Executive Surgery Center
Globe Newswire (09/13/16)

Surgical Care Affiliates, Inc., a leader in the outpatient surgery industry, has partnered with Executive Surgery Center effective August 1, 2016. This partnership establishes SCA's presence in the Houston market as SCA continues to strategically collaborate with physicians and health plans to provide patients access to high quality care at lower cost.
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Health-Services Spending Takes Off, Raising Political Risk
Investor's Business Daily (09/09/16) Graham, Jed

Spending on health care services surged a greater-than-expected 6.9 percent, or $37.1 billion, from a year ago in the second quarter, according to Census Bureau data released Thursday. The acceleration in spending growth is a worrying sign after a period of moderating growth that followed an ObamaCare-fueled rise amid Medicaid and individual-market coverage expansions.
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Ohio Hospital Sues Over WV Certificate of Need Changes
Charleston Gazette-Mail (09/10/16) White, Kate

An Ohio hospital is suing the West Virginia Health Care Authority over changes to the certificate of need process, which in-state hospitals are no longer required to undergo. The lawsuit Marietta Memorial Hospital filed in federal court in Charleston last week claims it's unconstitutional to make out-of-state hospitals continue to apply for a certificate of need to "construct, acquire or develop an ambulatory care center" in West Virginia.
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Governor Weighs Legislation on Surprise Medical Bills
California Healthline (09/19/16) O'Neill, Stephanie

In California, it is not unusual for patients to be hit by large, unexpected medical bills when they are unwittingly treated by someone outside their insurance company's network. A 2015 survey by Consumers Union found that nearly 1 in 4 Californians who'd had hospital visits or surgery in the previous two years reported receiving an unexpected bill from an out-of-network provider.
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Official Hints at Settlement Talks With ObamaCare Insurers
The Hill (09/14/16) Sullivan, Peter

A top Obama administration health official indicated Wednesday that there are discussions underway about a possible settlement with insurance companies over ObamaCare payments. The possibility of settlements has drawn alarm from Republican lawmakers, who warn that the administration is seeking to get around limitations set by Congress.
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Insurers, Physicians Can Partner to Save Costs
Advance for Health System Management (09/12/16)

Insurers and physicians can partner to help physicians to deliver care more efficiently and save costs, according to a study by researchers at Rice University and Cigna, a global health service company, as cited by a press release from Rice. The study's findings are based on an examination of an arrangement Cigna made with a multiclinic physician practice in north Texas to improve quality of service and lower healthcare costs for patients covered through Cigna.
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Information Compromised for 14,000 Patients of University Gastroenterology
Turnto10.com (09/15/15) Volz, Emily

Names, birthdays, Social Security Numbers: everything scammers need to steal your identity. And now they have it, because of a data breach at University Gastroenterology, known as UGI, which has 19 locations across Rhode Island.
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Connecticut Toddler Is 4th Rare 'Superbug' Case
Associated Press (09/09/16)

A fourth U.S. person has been diagnosed with bacteria resistant to a last resort antibiotic, but researchers are expressing relief that so far these superbug precursors have not spread to others. The latest case is a 2-year-old Connecticut girl who was diagnosed earlier this year, the Centers for Disease Control and Prevention reported Friday.
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Wills Eye in Medicare Dispute
Philly.com (09/15/16) Brubaker, Harold

Wills Eye Hospital and Medicare are in a heated licensing dispute centered on the ratio of inpatient to outpatient services a facility must provide to qualify as a hospital. Both sides say the outcome could have "cataclysmic" consequences.
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Get a New Body Part and Go Home the Same Day: The Rise of the 'Bedless Hospital'
STAT News (09/16/16) Ross, Casey

Get in, get a new knee, go home. As treatments get less invasive and recovery times shrink, a new kind of hospital is cropping up — the "bedless hospital."
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