The Ambulatory Surgery Center Association (ASCA) annually asks members to participate in a â€œfly-inâ€ to meet with members of Congress to raise awareness about the implications of health care policies. As ASCA vice president of government relations Steve Miller notes, there is nothing like hearing directly from a constituent to get a legislatorâ€™s attention.
The 2013 ASCA fly-in to Washington, DC, will take place September 17 and 18. Several state ambulatory surgery centers (ASCs) have appointed delegations to represent them at the fly-in. Any ASC representative may participate individually.
On the first day, participants will meet with ASCA staff to review the most critical issues subject to regulation and to identify policy positions that will benefit the ASC industry.
One such issue is the ASCA Quality and Access Act of 2013, which was introduced in the House of Representatives in late June by John Larson (D-Conn) and Devin Nunes (R-Calif). This bill is the companion legislation to S. 1137, which was introduced by Senators Ron Wyden (D-Ore) and Mike Crapo (R-Idaho) earlier in June.
The bill includes a long sought-after feature: Medicare reimbursement for ASCs would be computed using the same market basket price index used for hospitals. The bill also would direct the Centers for Medicare and Medicaid Services (CMS) to add an ASC representative to the advisory committee on payment for outpatient services.
ASCA estimates that Medicare would save $2.5 billion annually if half the eligible procedures now performed in hospital outpatient departments (HOPDs) were moved to ASCs. This is because ASC services are reimbursed, on average, at 58% of the rate paid to HOPDs.
ASCA also hopes to convince Congress to change CMS policy on payment for colonoscopies. For routine screening, patients are not charged a copay. However, if during the examination the physician finds and removes a polyp, the procedure is deemed â€œdiagnosticâ€ and a copay is required.
As an observer notes, the least affluent patients are discouraged from having screening examinations and thus have to accept a health risk for financial reasons.
A third bill ASCs hope to see passed is a modification to the timeline for establishing electronic health records (EHRs).
The 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) requires hospitals and physicians to adopt EHRs or face reductions in Medicare payments beginning in 2015. ASCs have asked for a delay in the implementation timeline. A provision in the Electronic Health Records Improvement Act, introduced in March 2013 in the House of Representatives, would give a 3-year exemption for treatment in ASCs.
Face time in Congress
On their second day in Washington, fly-in participants will meet with their representatives and senators or with staff members to present their views.
It is only through such personal contact that lawmakers will be able to understand the real-life implications of their decisions, according to Keith Metz, MD, chairman of the ASCA government affairs committee. â€œASC supporters who commit to spending a day in Washington demonstrate to legislators and their staffs the importance they place on the ability to work and practice in an ASC,â€ he says. â–