ASCA Plans to Reintroduce Medicare Outpatient Surgery Legislation

The Ambulatory Surgery Center Association (ASCA) is ready for the 118th congressional session, and its list of priorities includes the reintroduction of the Outpatient Surgery Quality and Access Act of 2021.

The push for the reintroduction of the complete Outpatient Surgery Quality and Access Act of 2021 is a top priority for the ASCA. According to ASC Focus, an ASCA publication, this prioritization is shared by “current bill sponsors in both the House and Senate.”

Also, according to ASC Focus, “ASCA plans to follow the reintroduction of the bill with a significant showing in the halls of Congress.” ASCA will do this during its National Advocacy Day fly-in. Per the ASCA website, the National Advocacy Day program helps “members build relationships with the policymakers who make the decisions that directly impact the ASC community and its patients.”

The upcoming National Advocacy Day will run from February 27, 2023 through March 1, 2023. Per the ASCA website, ASCA “schedules a full day of congressional meetings on Capitol Hill for each participant.” This is the first time ASCA members will be able to meet with policymakers in person since the pandemic.

The Act aims to protect Medicare beneficiaries’ access to “high-quality outpatient surgery.” The Act’s provisions are designed to address existing issues. Per the ASCA website, the Act includes the following provisions:

• align the reimbursement update factor for identical outpatient procedures which helps to align ASC and hospital outpatient departments (HOPDs) payment systems;
• provide beneficiaries with outpatient surgery quality information, a provision that directs HHS to “publish a comparison of quality measures that apply to both ASCs and HOPDs”;
• add an ASC representative to the Advisory Panel on Hospital Outpatient Payment which ensures that the Advisory Panel has at least one representative from the ASC community;
• create a review process for potential outpatient procedures to address the issue that “there is no formal process for stakeholders to use to request codes be added to the ASC Covered Procedures List (ASC-CPL)”;
• eliminate the copay penalty for Part B Services, a provision which “applies the same framework that applies to HOPD services”; and
• allow ASC services to grow naturally, this provision “directs the agency to combine ASC and HOPD volume and calculate one outpatient weight scalar.”