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OOSS Submits Comments to CMS: 2020 Proposed Payment Regulation

On September 27, OOSS submitted comments on behalf of ASCRS, the American Society of Retinal Specialists (ASRS), and the Society for Excellence in Eyecare (SEE) to the Centers for Medicare and Medicaid Services (CMS) regarding its proposed 2020 ASC payment regulation.

A few highlights:

  • For years, we have strenuously objected to CMS’ use of the Consumer Price Index (Urban) as the update factor for ASCs,Last year, CMS adopted instead the Hospital Market Basket (HMB) as the ASC annual update factor (which is typically about a point higher) for the period 2019 through 2023. We recommended that CMS permanently utilize the HMB as our update factor.
  • We recommended that the agency discontinue the rescaling of ASC relative weights and apply full HOPD relative weights to ASC services.Rescaling has had the effect of arbitrarily and inappropriately reducing ASC payment rates and causing a substantial divergence in payment rates between HOPDs and ASCs that is unrelated to the costs of delivering services in those settings.
  • We continued to support a proposed ASC quality measure on TASS that was developed by the ASC Quality Collaboration (on whose Board OOSS sits).
  • We strongly urged CMS to remove FDA-approved intracameral drugs that are used for pain and inflammation as a “covered service” within our facility fee and pay for them separately under Medicare Part B.
  • We suggested that, to the extent feasible, ASCs and hospitals should collect the same quality data and that such data (as well as comparable out-of-pocket cost information) should be made available in a format that enables beneficiaries to make meaningful comparisons and choices between hospital and ASCs.

REVIEW OOSS’ COMMENTS TO CMS ON THE ASC RULE.


OOSS is delighted that CMS has made these changes in Medicare regulations.  We will be providing further guidance to our members to enable you to be in compliance with these new policies.  Please plan on attending the OOSS Symposium on Saturday, October 12 in San Francisco as we will be addressing these comments during the meeting.  For details and to RSVP visit: Symposium 2019, or RSVP via the OOSS App.

Should you have any questions, please contact our Washington Counsel, Michael Romansky, at mromansky@OOSS.org.