Complete Story
08/29/2011
OAASC Member e-Newsletter
August 30, 2011
Member e-Newsletter
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Advocacy
Ohio Department of Health Revises Fees at OAASC Urging
The Ohio Department of Health (ODH) has proposed a revised inspection fees schedule for ASC and other health care facilities as a result of an OAASC inquiry.
Up to this point, the ODH has charged the same fee for both an in-person "field" and desk review for complaints. That fee is $875.00.
The OAASC contacted the ODH division in charge of these reviews and after some conversations, the department proposed revising their fee schedule to $875.00 for a field (in-person) review and $250 for a desk (in ODH office) review.
OAASC Executive Director Randy Leffler, testified at an ODH hearing on the change, complimenting ODH staff for their prompt and accommodating attitude and action on the issue. This demonstrates the new attitude within the Administration for more business friendly regulations.
Contact Senator Portman to Urge Support of ASCs
As one of 12 members of the Joint Select Committee on Deficit Reduction (the new select committee to deal with the US budget), Senator Rob Portman would like to hear from constituents with ideas for addressing the federal budget.
Of course many federal programs will be considered in deficit reduction discussions, Medicare among them.
Please visit his site: http://portman.senate.gov/public/index.cfm/reduce-the-deficit to let Sen. Portman know how encouraging greater utilization of ASCs can save the Medicare program significant dollars, while continuing and even improving the quality of services. The OAASC will also be providing comments to Sen. Portman.
Click here for talking points on what to tell Sen. Portman.
Request CMS to Delay Quality Reporting Requirement
The Centers for Medicare and Medicaid Services (CMS) recently issued proposals for a mandatory ASC quality reporting program.
Although the OAASC and Ambulatory Surgery Center Association (ASCA) is generally suppotive of quality reporting, there are concerns about many of the issues raised by these proposals. The proposal that would require ASCs to submit quality data beginning on January 1, 2012 is foremost among our concerns.
We are urging CMS to delay the required data submission until October 1, 2012 to allow for more time for ASCs to prepare for this new program. You can help us stress the importance of this delay by submitting a letter to CMS on behalf of your center.
Click here for a copy of the letter and details.
Join Ohio ASCs in Washington D.C. on Oct. 13
The OAASC is joining with the ASC Association to hold an Ohio fly-in day in Washington D.C. on October 13th.
The event will be just for Ohio ASCs and we will be meeting with key Ohio Congressional members.
We are encouraging members to fly/drive in to Washington in the afternoon or evening on October 12th. Our day will start early on the October 13th. You will be scheduled to meet with your local representative's office and other Ohio congressional staff/reps. We will finish in the afternoon, with plenty of time to catch a flight, start your drive home or go see the sites.
Details will be coming soon, but if you or anyone on your staff are interested in joining, please contact Randy Leffler at rleffler@oaasc.net or 614-358-0177.
Reimbursement
Some ASCs Receive Takeback Notices from CIGNA
With the recent switch to CIGNA from Palmetto as the region's Medicare Administratve Contractor, some centers have reported receiving "takeback" notices from CIGNA for payments made by Palmetto.
While the dollar amounts are not often large, it did raise a number of questions for OAASC members.
According to the CIGNA representative, the overpayments are a result of the Affordable Care Act adjustments, for claims with dates of service January 2010 – May 2010, originally processed before the middle of May, 2010.
Unlike the Medicare Physician fee schedule, the revised ASC fee schedule reduced several allowed amounts for services rendered in an ASC facility. Fee schedules for ASCs are calculated using OPPS payments. Please see MLN Matters article MM7010, http://www.cms.gov/MLNMattersArticles/Downloads/MM7010.pdf.
The updated fee schedule is available on the OAASC web site under the Reimbusement link in the MYOAASC section. Please contact the OAASC with any questions or concerns.
Provider Enrollment Revalidation - Wait Until You Hear From Your Medicare Administrative Contractor (MAC)
All providers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to submit their enrollment information so they can be revalidated under new risk screening criteria required by the Affordable Care Act (section 6401a). Providers/suppliers who enrolled on or after Friday, March 25, 2011 have already been subject to this screening, and need not revalidate at this time.
Do NOT submit your revalidation until you are notified to do so by your MAC. You will receive a notice to revalidate between now and March 2013.
This will allow MACs to process revalidations in a timely fashion and allow providers to take advantage of innovative technologies and streamlined enrollment processes now under development. Updates will be shared with the provider community as these efforts progress.
For more information about provider revalidation, review the Medicare Learning Network's Special Edition Article #SE1126, titled "Further Details on the Revalidation of Provider Enrollment Information."
Ohio BWC Prepares for Payment Updates
The Ohio Bureau of Workers' Compensation (BWC) is again preparing for their yearly update of ASC rates. For the past few years, the fee schedule has remained at 100 percent of the newly adjusted Medicare rates for all procedures except pain management procedures, which has been reimbused at 110 percent.
Specifically, the BWC is requesting the following information from Ohio ASCs to address the fee schedule: quality and cost data for ASCs, and procedure that should be added to the BWC's ASC schedule.
The OAASC's Reimbursement Committee is working on these issues, but if you have specific information that impacts your center or would be helpful to the OAASC's argument, please contact Randy Leffler at rleffler@oaasc.net.
How Do Your Center's Insurance Payments Stack Up?
OAASC's Reimbursement Survey Provides the Answer
The OAASC has created a tool that provides Ohio ASCs with a clearer picture of third party payer payment trends.
The OAASC developed and implemented a survey to gather reimbursement data from members, statistcally analyzed that data for accuracy and ensured that the survey and its results were well within legal boundaries.
Compliance
What Has Your Center Done to Meet the Medicare CfC on Infection Prevention?
Continuing Education - In Service Training - Infection Prevention Officer - IP Program
OAASC's Exclusive Pre-Conference Program Infection Prevention for ASCs
Wednesday, September 14th at 12:00 noon – 3:00 p.m.
This half day pre-conference program on Infection Prevention in the ASC will feature nationally known speakers, Gail Bennett and Linda Spaulding addressing effective IP program, sterilization and disinfection, organisms of concern in ASC patients, and other issues of importance to you and your center. This fast paced, informative program will provide excellent, evidence-based information to enhance your current IP program.
Attendance will meet CMS requirements for infection prevention continuing education. All participants will receive a certificate of participation, electronic version of power points for in-service training and continuing education.
Click here for more information and to register.
Member Q&A
Fellow members need your assistance in answering critical questions for their ASCs. Additionally there is great information and resources available for centers across the state.
One of the latest Q&A involves:
RNs vs CRNAs for sedation
Q. Does your surgery center use RNs for conscious sedation vs CRNAs for MAC sedation?
There are over eight responses including:
In the past when I worked at a multi-specilaty ASC RNs were used for pain clinic patients and for GI patients who received conscious sedation. At our center we do only ophthalmology and we do use CRNAs. We have an anesthesiolgist in house in addition when the schedule requires there is an CRNA here. CRNAs work with monitored anesthesia or MAC cases.
OAASC's Q&A section of the OAASC website allows members to share common questions and answers on issues impacting the ASC community in Ohio. Send us your answer and we'll post them on the web site. If you want to submit a question, email Randy Leffler at rleffler@oaasc.net. To see the responses to previous questions, click here.
