Payment Matters: CMS Proposes Ambulatory Surgical Center Quality Reporting – and Eventual Medicare Reimbursement Reduction – Rule

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The proposed Medicare Hospital Outpatient Prospective Payment System (OPPS) for calendar year 2012 includes the Ambulatory Surgical Center Quality Reporting Program [PDF] proposed rule (ASC QRP). The proposed ASC QRP will require each ASC to report seven claims-based elements beginning on January 1, 2012, and, if not reported, an ASC could receive a reduction in Medicare reimbursement of up to 2% as early as calendar year 2014. The ASC QRP would require each ASC to report additional elements in 2013 and 2014 that, if not reported, could reduce that ASC’s Medicare reimbursements in 2015 and 2016. Comments on the proposed ASC QRP are due by September 16, 2011.

The initial required elements include seven claims-based elements and one element reported via the National Health Safety Network (NHSN).

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