04/02/2014

CMS and Congress Make ASC Medicare Changes

Delays in Cataract Quality Reporting Measure and ICD-10 Coding Implementation

CMS and Congress Make ASC Medicare Changes

 Delays in Cataract Quality Reporting Measure and ICD-10 Coding Implementation

 

There have been many changes this week (3/31/2014) for Medicare ASCs thanks to both CMS and Congress.

 

First, CMS has just announced that it will delay the implementation of the Quality Reporting Requirement 11:  Cataracts – Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery measure (NQF #1536) until January 1, 2015. 

 

This measure was adopted in the last ASC payment rule.  CMS had delayed the reporting requirement until April 1, 2014 from January 1, 2014. The change now extends it for a full year until January 1, 2015. 

 

According to their announcement, “while CMS continues to believe that the functional status of the patient after cataract surgery should be a concern for the ASC, it recognizes operational difficulties with this specific measure and is delaying the start of data collection from April 1, 2014 until January 1, 2015. CMS intends to issue proposals regarding data collection for this measure in the upcoming CY 2015 OPPS/ASC proposed rule with comment period.”

 

OAASC Advocacy through Ohio U.S. Senator Sherrod Brown likely contributed to this implementation delay. Thanks to all OAASC members who contacted Senator Brown’s office to make our case on this issue.

 

This delay does not affect the data collection period for any other quality measures under the ASCQR Program.

 

Data collection for two endoscopy measures finalized along with the cataract measure did begin with April 1, 2014 services. These are ASC-9:  Endoscopy/Polyp Surveillance: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Patients (NQF #0658) and ASC-10:  Endoscopy/Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of Inappropriate Use (NQF #0659).

 

According to the ASCQR contractor, the data collection period for those measures begins on April 1, 2014. Facilities can collect these data anytime during the collection period of April 1, 2014 to December 31, 2014, with no requirement to begin on April 1^st. 

 

CMS said that they realize that this is the first year of this type of data collection effort for ASCs and believes that this lenient approach of allowing a sample of patients for reporting purposes allows ASCs sufficient time to set up operations for this data collection. 

 

The ASCQR Support Contractor is available to provide technical assistance to facility staff and will be providing specific assistance for these measures in the upcoming months. Measure specifications, data collection flow charts, data collection tools for the new measures, as well as a recorded session covering this information held February 5, 2014, is available on the support website at http://www.oqrsupport.com/asc/webinars#a2014. 

 

 

Secondly, Congress passed and the President has now signed a one-year delay in the implementation of ICD-10 coding structure for one year. The change was a part of a patch to postpone a 24 percent cut in Medicare payments to physicians scheduled to take effect April 1.

 

For specialty physicians and surgeons there is a provision used to pay for the $20 billion “patch” that implements severe payment cuts for services that are deemed to be ‘misvalued’ within the Medicare physician payment system.

 

This provision is part of an effort to cut payments to specialists while increasing the value of primary care services in the Medicare program. In addition, one of the other ways the legislation was paid for was by increasing the Medicare sequester payment cut for 2024 from 2% to 4% for the first six months of the year. After six months the cut would drop to zero.

 

Short term advocacy regarding the specialist provision will take place immediately.  Physicians interested in making their case should join their Ohio colleagues for our June 17-18 for our Washington D.C. fly-in.

 

Join Your Ohio ASC Colleagues in Washington D.C.

 

 

For more information on this issue or if you have any questions, please do not hesitate to contact OAASC’s Randy Leffler at rleffler@oaasc.net or at 614-358-0177.

 

Thanks to QualityNet and ASCA for portions of the above information.