Issues
Burdensome Regulatory Environment


texas county mapThe proposed emergency preparedness rule has a number of flaws, burdening ASCs with requirements that go beyond their scope of care. The proposed rule places the same requirements on all providers and overlooks their unique aspects. Many of the proposed requirements are not practical for the ASC setting given their smaller size and staff constraints.

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Data Collection and Quality Reporting
The Texas ASC Society is supportive of efforts to improve the quality of care and increase provider transparency through the use of data. TASCS requests that organizations obtain data in the least burdensome manner and that collected data is used for tangible purposes with stated goals.
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Licensing and Regulatory
Texas surgery centers are licensed by the Texas Department of State Health Services. Many Texas ASCs are also certified Medicare providers. Ambulatory surgery centers are also governed by regulations established by departments of insurance, occupational health agencies, physical plant and safety standards and many other regulatory bodies.
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Managed Care
The Texas ASC Society's position on managed care covers a broad range of topics, including out-of-network, network and reimbursement adequacy, state and federal insurance regulations and payer contract language.
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Medicare
While the new Medicare payment system recognizes a number of surgeries and procedures that can be performed in the ASC setting, the disparity between hospital outpatient (HOPD) and ASC rates is so wide that it forces a lot of surgeries out of the ASC setting.
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Medicare Approved Procedures
The Medicare ASC approved procedures list is a dynamic document that lists the procedures that Medicare has deemed appropriate to be performed in an ambulatory surgery center. The Texas ASC Society supports the addition of new approved procedures as surgical methods advance.
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Medicare Payment Adequacy
Most Texas surgery centers are also certified Medicare providers. Medicare establishes a fee schedule for all procedures that it deems appropriate to be performed in an ambulatory settings. The Texas ASC Society advocates on behalf of surgery centres to ensure that procedure payments are adequate, that the Medicare ASC approved procedure list is properly updated and that annual inflation adjustments reflect the increasing costs of providing surgical services.
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Network Adequacy
The Texas ASC Society works to ensure that surgery centers are able to work in conjunction with health care plans and that State insurance regulations reflect the interests of the surgery center industry.
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Physician Ownership
A study by the Medicare Payment Advisory Commission (MedPAC) found that approximately 90 percent of all ASCs nationally are physician-owned. In Texas, that number is even higher. Surgeon investment leads to an efficient and high-quality operation for patients.
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Workers Compensation
In 2008, TASCS served as the industry’s stakeholder during the state’s process for the new Workers’ Compensation rule. It resulted in rates and regulations that will ensure that patients can seek their workers’ comp care in the ASC setting. While several other states have made cuts to ASCs in the workers’ comp system to achieve savings, TASCS has worked with Texas policymakers to make sure that patients do not lose access to the ASC setting.
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