A delay by the Centers for Medicare & Medicaid Services (CMS) in updating the interpretative guidelines that are used by state Medicare surveyors has created problems for several ASCs during their surveys. As of December 23, 2011, based on a rule change announced last fall, ASCs can now notify patients of their rights, the ASC’s advance directive policies and the list of the ASC’s physician investors on the day of surgery. The interpretive guidelines used by state Medicare surveyors, however, have not been revised to reflect this change and are, therefore, out of date. As a result, state Medicare surveyors who rely solely on the interpretive guidelines have incorrectly cited ASCs for noncompliance when those ASCs did not notify patients of the required information prior to the date of surgery.
ASCA has contacted CMS regarding this issue and requested its help in assuring that surveyors are informed of the change and that the interpretive guidelines are updated as soon as possible. A memo explaining the change is available in the ASCA Connect Public Resource Library. This document can be used by ASCs if they encounter a state Medicare surveyor who is unaware of the change in the notification requirements. ASCA members that experience survey problems with this or other issues should contact Jonathan Beal at jbeal@acsassociation.org..
This year, the Ambulatory Surgery Center Association (ASCA) will be hosting two National Capitol Fly-In events. One will be held on April 18-19 and the other June 19-20. Eight states—Texas, California, Florida, Tennessee, Arizona, Massachusetts, New Hampshire and Ohio—have already committed to participating. Several other states, including Oklahoma, Kansas and Georgia have also expressed interest in visiting their legislators on Capitol Hill.
More than 80 percent of the cosponsors for the Ambulatory Surgical Center Quality and Access Act of 2011 signed on last year thanks to grassroots advocacy efforts by ASCA members who took the extra step of reaching out to their elected officials.
Help build on last year’s successes and strengthen the support for the ASC community from Congress. Encourage ASC professionals in your state to become politically active and to talk with their elected and appointed officials about ASCs.
For more information on how to get involved in the 2012 National Capitol Fly-In program or in other ways, contact Morgan Hanson at mhanson@ascassociation.org.
The ASCA Board of Directors has approved the formation of two new committees within the Government Affairs Department and set them to begin operations on January 1 this year. The first committee is the State Affairs Committee, which is charged with “fostering better communication and coordination between ASCA and the state associations, in order to facilitate information sharing and eliminate duplication of effort.” An initial task of the committee will be surveying state association contacts regarding current programs and potential new programs to help fulfill the committee’s charge. The committee consists of nine state association leaders in seven different geographic regions, and one member who will represent ASCA’s corporate members. The committee is comprised of the following:
Carol Blanar, RN BS CNOR
Executive Director, Indiana Federation of Ambulatory Surgery Centers
Bobby Hillert
Executive Director, Texas Ambulatory Surgery Center Society
Craig Jeffries
Corporate Representative on behalf of corporate members Nueterra Healthcare and AmSurg Corporation
Beth LaBouyer
Executive Director, California Ambulatory Surgery Association
Randy Leffler
Executive Director, Ohio Association of Ambulatory Surgery Centers
Peter Lohrengel (Chair)
Executive Director, Florida, Georgia, Mississippi, South Carolina and Tennessee state associations
Mark Mayo
Executive Director, Ambulatory Surgery Center Association of Illinois
Joyce Meisel, BSN RN CASC
President, New Hampshire Ambulatory Surgery Association
Sheri Sass
Administrator, Idaho Ambulatory Surgery Center Association
Robert Schwartz
Executive Director, Colorado, Oregon and Washington state associations
The second committee is the Government Affairs Committee, which is charged with overseeing the operations of the Government Affairs Department. Among the items that the committee has been tasked with are the establishment of a legislative and government affairs agenda for ASCA and the development of a policy-making process for legislative and regulatory issues. The committee is comprised of the following 12 members:
Jesseye Arrambide, RN BSN CNOR
Executive Director, Oregon Outpatient Surgery Center
David Ayers
Chief Executive Officer, Nueterra Healthcare
Jo Ellen Braden, RN CASC
Administrator, Marysville Ohio Surgical Center, LLC
Dave Fitzgerald
Chief Executive Officer, Proliance Surgeons, Inc
Richard Francis, Jr.
Chairman & Chief Executive Officer, Symbion, Inc
Andrew Hayek
President & Chief Executive Officer, Surgical Care Affiliates
Chris Holden
President, Chief Executive Officer & Director, AmSurg Corporation
Sarah Martin, MBA RN CASC
Vice President of Operations, Meridian Surgical Partners
Keith Metz, MD (Chair)
Medical Director, Great Lakes Surgical Center, LLC
David Shapiro, MD CASC
Partner, Ambulatory Surgery Company, LLC
Jill Sluder, RN CASC
Administrator, Summit Ambulatory Surgery Center
Bill Wilcox
Chief Executive Officer, United Surgical Partners International
For more information, contact Steve Miller at smiller@ascassociation.org.
Earlier this week, Governor Chris Christie pocket-vetoed legislation that would have required surgical practices with only one operating room (OR) to be licensed by the New Jersey Department of Health and Senior Services (DHSS). A pocket veto applies only to bills passed within the last 10 days of a two-year legislative session, and is the only type of veto in which the Governor does not return the bill to the legislature for a possible override vote.
Hospitals and multiple-OR surgery centers have been under the purview of the DHSS, but the State Board of Medical Examiners currently oversees one-OR surgical practices. Throughout the legislative process, DHSS voiced concerns about the financial burden that would be created by requiring the department to also license and inspect one OR surgical practices.
The New Jersey legislature had passed SB 2780 (AB 4099) by a substantial majority last week. The legislation was supported by the New Jersey Association of Ambulatory Surgery Centers (NJAASC), the New Jersey Hospital Association and the Medical Society of New Jersey.
Jeffrey Shanton, chair of the Advocacy & Legislative Affairs Committee for NJAASC, stated that “to say I’m disappointed would be an understatement.” He confirmed, however, that the association will continue to work hard to pass legislation regarding one-OR facilities. “The NJAASC will sit down with [DHSS] Commissioner Conroy and try to iron out the issues. We continue to believe that this legislation is imperative for the industry, and most importantly for the patients.”
Governor Christie did, however, sign SB 1988 (AB 3646), which phases out the state's cosmetic medical procedure gross receipts tax. Currently, consumers of cosmetic procedures are charged a 6 percent tax on the gross receipts from any cosmetic medical procedure they receive. This legislation will reduce the tax each year until July 1, 2014, when cosmetic medical procedure patients will no longer be charged a gross receipts tax. The first reduction will occur in July 2012, when the tax rate will be reduced to 4 percent.
For more information, contact Kara Marshall at kmarshall@ascassociation.org.