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CMS May Change ASC Billing

August 27, 2007
by root
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The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule to revise the requirements that ambulatory surgical centers (ASCs) must meet in order to bill Medicare for services furnished to beneficiaries.

The rule would update the existing ASC Conditions for Coverage (CfC) to reflect contemporary standards of practice in the ASC community, as well as recommendations from the HHS Inspector General. According to CMS, the new requirements are designed to promote and protect patient access to quality services in ASCs.

ASCs are typically free-standing facilities that perform outpatient surgery. To participate in the Medicare program, they must meet Medicare's conditions for coverage.

Proposed rule changes include:

· A more comprehensive quality assessment and performance improvement condition (QAPI) that enables ASCs to take tailored proactive steps to ensure quality care;

· Requiring the ASC's governing body to be responsible for the oversight and accountability for the updated QAPI program;

· Adding a new disaster preparedness plan standard to address emergency preparedness within the facility and interaction with local and state officials.

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