American Society of Plastic Surgeons
For Consumers

STATE | ASPS Supports ASC Payment Parity

During ASPS's Advocacy Summit, members worked to advance the Ambulatory Surgical Center Quality and Access Act, introduced by Reps. Devin Nunes (R-CA-22) and John Larson (D-CT-01). The legislation would update the reimbursement fee schedule for ambulatory surgical centers (ASCs) from the consumer price index for all urban consumers (CPI-U) to the hospital market basket; require the Centers for Medicare and Medicaid Services (CMS) to make quality metrics of ASCs and hospital outpatient departments (HOPDs); add ASC representation to the Advisory Panel on Hospital Outpatient Payment, which controls aspects of physician payments; and require CMS to disclose criteria used to deny procedures from being performed in ASCs.

This timely effort came on the heels of a markup of the Ambulatory Surgical Center Payment Transparency Act, which is a newer piece of legislation also sponsored by Reps. Nunes and Larson. While ASPS supports the Payment Transparency Act, it lacks two key aspects of the ASC Quality & Access Act that are necessary to ensure that ASCs are more fairly reimbursed and better represented at the federal regulatory level in the future. Specifically, the Payment Transparency Act fails to update the reimbursement fee schedule and does not require CMS to make quality metrics of ASCs and HOPDs publicly available.

Following the introduction of the Payment Transparency Act, ASPS sent a letter to Reps. Nunes and Larson thanking them for their commitment to implement positive changes to increase transparency and increase ASC representation on the CMS decision-making panel regarding hospital outpatient payment. However, the letter requests that Reps. Nunes and Larson add the reimbursement fee schedule language from the ASC Quality & Access Act to the Payment Transparency Act.