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The Trouble With Transvaginal Mesh - August 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 26 of 128

providers, but CMS is trying to push these hospital facilities to become as efficient and low-priced as independent physicians and ASCs," says Michele Molden, MBA, FACHE, of the Advisory Board, a Washington, D.C., consulting firm. Site neutrality also could slow ASC-to-HOPD conversions, says Kara Newbury, JD, regulatory counsel for the Ambulatory Surgery Center Association (ASCA), as hospitals would have less incentive to acquire ASCs and confer upon them HOPD status to secure the higher Medicare rates paid for outpatient services performed in hospital-owned surgical centers. (Of the 285 ASCs that left the Medicare system from 2009 through 2013, at least 101 were converted to HOPDs, says ASCA.) Physicians, who'll be paid for procedures at off-campus sites at the non-facility Medicare Physician Fee Schedule (MPFS) rates, should reassign their billing rights to the hospital so it can submit claims to Medicare on their behalf and collect its portion of the payment to cover facility fees, says Cheryl Storey, CPA, a partner in the Moss Adams healthcare group. One notable exemption to site neutrality: HOPDs that were billing under OPPS as of Nov. 2, 2015, will continue receiving payments under OPPS for those services after Jan. 1, 2017. GI moderate sedation. CMS is proposing to separate moderate sedation from GI endoscopy procedure codes to prevent paying endoscopists for sedating patients even when an anesthesia provider is present and billing CMS separately. Under this change, the value of moderate sedation would be backed out of the current value of the code and moderate sedation would be reported and paid separately when performed. For GI docs providing their own moderate sedation, there would be no financial impact, says the American Gastroenterological Association. Instead, these physicians will report 2 M A Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 2 7

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