In June of 2013, US Senators Ron Wyden (D-OR) and Mike Crapo (R-ID) and US Representatives Devin Nunes (R-CA) and John Larson (D-CT) introduced the Ambulatory Surgical Center Quality and Access Act of 2013 (H.R. 2500 / S. 1137) into the US Congress.
Download the ASC Quality & Access Act of 2013 issue brief.
Cosponsors in the House and Senate
Letters of support
Ambulatory Surgical Center Quality and Access Act of 2013 - 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.
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 Value-Based Purchasing Program that saves Medicare money and provides a bonus pool to ASCs that meet certain quality standards.
3. Directs CMS to add a representative of the ASC community to be appointed to the Advisory Panel on Hospital Outpatient Payment.
4. Creates more transparency within the Medicare procedure approval process by requiring CMS to disclose which of six criteria triggers the exclusion of a procedure from the ASC approved list.
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.
Prior Legislative Success
Several parts of the previous version of the legislation, the ASC Quality & Access Act of 2011, were 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.