Federal Regulations

ASCs are highly regulated healthcare facilities and must comply with a host of federal regulations and statutes. These laws cover all aspects of ASCs from their day-to-day operations to how they are paid. Most ASCs provide care to Medicare beneficiaries and, thus, must demonstrate continual compliance with Medicare standards. However, there are additional federal laws all ASCs must comply with, such as the Health Insurance Portability and Accountability Act (HIPAA). Below you will find recent federal actions, separate from annual Medicare payment updates, that are impacting ASCs.

Medicare Legislative Priorities

In 2023, a bipartisan group of legislators introduced the Outpatient Surgery Quality and Access Act of 2023 (H.R. 972/S. 312). This legislation expands access to quality, more affordable outpatient surgical care offered at ASCs across the country by enacting changes such as capping copays, improving transparency through price and quality comparison tools, and ensuring ASCs receive fair Medicare reimbursement rates.

Cures Act Final Rule

On May 1, 2020, the Office of the National Coordinator for Health Information Technology (ONC) published the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, (Cures Act) Final Rule. Per this regulation, ASCs should be aware to avoid “information blocking”, or practices “likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information.”

No Surprises Act

In December 2020, the No Surprises Act (NSA) established new protections for consumers against surprise bills in certain emergency and nonemergency scenarios. As of January 1, 2022, ASCs must comply with several new regulations, including patient disclosures, provider directory upkeep, and good faith estimates (GFEs) of expected charges for certain patients.

HIPAA Resources

In 1996, the Health Insurance Portability and Accountability Act, commonly known as HIPAA, was signed into law. In the decades since passage, this law has reshaped rules around security and privacy of protected health information.