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Why Can't He Eat or Drink After Midnight? - March 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 41 of 160

4 2 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 6 • ASCs to MedPAC: Thanks for nothing. The Medicare Payment Advisory Commission (MedPAC) thinks that Medicare payments to ambulatory sur- gical centers should stay flat next year. MedPAC's reasoning: More patients are having surgery at ASCs, so this should help offset any financial hardships caused by the stagnant payments. This isn't a new recommendation from MedPAC, which has unsuccessfully recommended eliminating the ASC payment update for several years, including in 2015 and 2016. The current recommendation is not binding, and instead MedPAC will present their comments to Congress in March, with the payment update finalized this fall. Meanwhile, MedPAC recommends a 1.65% payment increase in hospital inpatient and outpatient services in 2017. • Site-neutral payments coming in 2017. Certain off-campus hospital outpatient depart- ments may face lower reimbursements starting in 2017. As part of the latest budget deal from Congress, new physician-based centers located off of the main campus of a hospital will receive reimbursement rates based on the ambulatory surgical center prospective payment system or the Medicare physician fee schedule. The change affects those facilities established after Nov. 1, 2015, and located more than 250 yards from the hospital's main campus. HOPDs established before the November cutoff date will be grandfathered in and continue to be reimbursed accord- ing to the Medicare outpatient prospective payment system (OPPS) schedule. The move is meant to curtail the practice of hospitals acquiring physician offices and outpatient facilities, and then billing under the higher-rate hospital OPPS. While the government says that the move will save Medicare millions, the American Hospital Association said in a statement that the site-neutral payments "may endanger patient access to care, especially among patients who are sicker, the poor, minorities and seniors who often receive care in hospital outpatient departments." The new rule is scheduled to take effect Jan. 1, 2017. — Kendal Gapinski Reimbursement Roundup Coding & Billing CB

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