On November 2, 2018, the Centers for Medicare & Medicaid Services (CMS) released its final 2019 payment rule for ASCs and hospital outpatient departments (HOPD). In addition to 2019 payment rates, that rule contains new requirements for Medicare’s ASC quality reporting program. ASCs that do not meet the reporting requirements could be subject to future reductions in their Medicare payments.
In short, under the new rules, ASCs can stop reporting anything on Medicare claims beginning January 1, 2019. They can also stop reporting ASC-8 immediately and stop collecting data on ASC-10 on January 1, 2019. To qualify for their full payment update in 2020, however, facilities still need to report the data they collected in 2018 on measures ASC-9 and ASC-10 in 2019. Reporting on ASC-11 is already voluntary, so there are no additional reporting requirements tied to that measure.
Beginning in 2019, ASCs will also need to report information they began collecting in 2018 on two new measures—ASC-13: Normothermia and ASC-14: Unplanned Anterior Vitrectomy.
To help ASCs comply with all of Medicare’s 2019 quality reporting requirements, ASCA is making several free resources available to all ASCs. These include:
- a comprehensive analysis of the changes and new rules introduced in 2019 posted on ASCA’s website (a link to that information will be included here once it is available)
- a webinar titled “CMS Quality Reporting for ASCs,” which is now available on demand
- a short interview with ASCA Chief Executive Officer Bill Prentice that includes information about some of the quality reporting changes and ASCA’s insights into those changes
- responses to questions ASCA has received on the new rules (see below)
More information on Medicare ASC quality reporting compliance will also be presented at the ASCA 2019 Conference and Expo in Nashville, May 15–18, 2019. A registration fee is required to participate in that event.
ASCA recommends that all ASCs review the comprehensive compliance resources that ASCA provides. Please contact Kara Newbury with any other questions.