ASC Quality & Access Act of 2011 (HR 2108/S 1173)

Summary

Ambulatory Surgical Center Quality and Access Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to require alignment of updates for ambulatory surgical center (ASC) services under a revised prospective payment system (PPS) with updates for hospital outpatient department (OPD) services.

Background

In June of 2011, US Representatives Pete Sessions (R-TX) and John Larson (D-CT) and US Senators Ron Wyden (D-OR) and Mike Crapo (R-ID) introduced the ASC Quality and Access Act of 2011 into the US Congress. Since its introduction several parts of the legislation have been enacted by CMS regulations, including the elimination of same day patient notification restrictions and the enactment of a quality reporting program that utilized five of the six criteria suggested by the ASC community.

Bill Synopsis

  1. Changes the ASC update factor from the Consumer Price Index –Urban (CPI-U) to the more accurate Hospital Market Basket Index

  2. Establishes a quality reporting system for ASCs. (The quality reporting system instituted by CMS last year utilizes most of the criteria outlined in the legislation.)

  3. Establishes a Value-Based Purchasing Program that saves Medicare money and provides a bonus pool to ASCs that meet certain quality standards.

  4. Allows for efficiency in the delivery of care by allowing a patient to receive treatment on the same day that the procedure is ordered. (The restriction on same day surgery was eliminated last year partially due to pressures from the legislation highlighting a burdensome regulation.)

  5. Directs CMS to add a representative of the ASC community to be appointed to the Advisory Panel Payment Classification Group (APC).

Relevance to ASCs

ASC’s currently save the Medicare system $2.6 Billion a year and if just half of the eligible procedures were moved to the ASC setting from HOPDs it would save the system another $2.5 billion. Over the last 10 years, ASC reimbursement rates have declined in comparison to HOPD reimbursement rates and are now on average 58% of what an HOPD receives for a similar procedure. This is an unsustainable trend that must be stopped in order for ASCs to remain a viable alternative to the higher cost HOPD setting.


Congressional Cosponsors

US House: H.R. 2108

US Senate: S. 1173

Endorsements from Allied Organizations

American College of Surgeons (ACS)
American Society for Gastrointestinal Endoscopy (ASGE)
American Society of Interventional Pain Physicians (ASIPP)
Outpatient Ophthalmic Surgery Society (OOSS)

Letters of Support from State ASC Associations

California
Georgia
Florida
Louisiana

Maine
Tennessee

Additional Resources

Write a Letter to Congress
Write your members of Congress and ask that they support the ASC Quality and Access Act of 2011. After you write, encourage others at your facility — doctors, nurses, staff as well as patients and vendors — to write as well.

ASC Quality and Access Act of 2011 Issue Brief