Medicare Compliance & Reimbursement

Ambulatory surgical centers now have an updated list of the procedures Medicare has approved for ASC facility fee payments - but they'll have to keep waiting for an overdue reworking of payment rates. In a final rule published in the March 28 Federal Register, the Centers for Medicare & Medicaid Services updated the list of covered procedures for ASCs effective July 1, 2003. The list includes both additions and deletions from CMS' 1998 proposed rule on the subject. But despite the fact that new payment rates were due, by statute, on the first of this year, CMS is still working on that ever-more complicated project. The delay could be good news for ASCs - and it could also herald increased competition with hospital outpatient departments. That's because CMS seems committed to making sure ASCs don't get shortchanged in comparison with hospital outpatient departments. Lesson Learned: Competition between hospital outpatient departments and ambulatory surgical centers is likely to heat up even more once CMS develops a ratesetting approach for ASCs. To see the rule, go to http://www.access.gpo.gov/su_docs/fedreg/a030328c.html.