Double Dose of Good Regulatory News for ASCs
Medicare law promotes pricing transparency and removes EHR penalties.
E
very ambulatory
surgical center
should bow down
and give thanks to the 21
st
Century Cures Act, a law
that promotes pricing
transparency and protects
physicians who perform
cases in ASCs from EHR
penalties. Here's how
ASCs and their physician-
owners could benefit.
• Pricing transparency.
In 2017, Medicare on aver-
age will pay surgical cen-
ters 50% of what hospital
outpatient departments
(HOPDs) receive for pro-
viding the same surgical
services. This dramatic
ASC-HOPD pricing disparity will now be somewhat of a good thing for
surgical centers. That's because a provision in the Cures Act requires
the Department of Health and Human Services to create a searchable
website that will let consumers compare differences in their out-of-
pocket costs (assuming no supplemental insurance) and in the
Medicare beneficiary liability for various surgeries when those proce-
dures are performed in HOPDs and ASCs. With few exceptions, HOPD
charges for a procedure will exceed those at the ASC setting. It's a safe
Legal Update
Mark
F. Weiss, JD
Patients will have financial
information that compels
them to choose an ASC
for their surgery.
• CURES ACT Patients will be able to compare their out-of-pocket costs at a surgical
center hospital vs. a hospital outpatient department, thanks to the 21
st
Century Cures Act.
