CMS Monday (July 16) released a final rule that sets Ambulatory Surgical Center (ASC) payment rates at 67 percent of the corresponding outpatient prospective payment schedule (OPPS). As a result of heavy lobbying, this is a slight increase to the 62 percent of the OPPS rate included in the agency's earlier proposed rule. Also a result to ASIPP lobbying, CMS has soften the blow somewhat by transitioning this over a four-year period.

The ASC final rule allows ASCs to be paid for any surgical procedure that CMS determines doesn't pose a significant safety risk to Medicare beneficiaries when performed in an ASC and that isn't expected to require an overnight stay. As a result, the final rule adds about 790 procedures for ASC payment. Payments for procedures that have been performed predominantly in the office setting have been capped at the non-facility practice expense component of Medicare's Physician Fee Schedule in order to avoid creating an incentive for physicians to perform those procedures in ASCs.

The agency also issued a proposed rule that would update Medicare payment for services in HOPDs under the OPPS and would set new payment rates for ASCs under the revised system effective for services in calendar year 2008. The proposed OPPS/ASC rule, published concurrently with the final rule, would add several additional procedures, which would result in approximately 3,300 covered surgical procedures under the revised ASC payment system. CMS expects that, as a result of the significant expansion of surgical procedures paid in ASCs, beneficiaries will experience greater access to surgical services in appropriate settings.

Fact Sheet - Revised Payment Structure for ASC
Fact Sheet - Revised for Payment Proposal for Services in ASCs
Fact Sheet - Payment Policy Proposal for HOPD

CMS

ASIPP is offering a Comprehensive Pain Medicine Board Review Course for physicians seeking board certification or re-certification for ABMS Pain Medicine examination or for American Board of Interventional Pain Physicians Part I examination.

The review course will be held on Aug. 5-10 in Nashville, TN This six-day intensive Board Review Course is a CME activity which is geared to prepare physicians for their pain boards but can also serve an in-depth review of the specialty of pain medicine.

To register on-line or for more information on the review course or to register, visit our Web site.

Meetings

ABIPP Part I To Be Administered in August

ABIPP Part 1 exam will be administered in Nashville, TN, on Aug. 11, 2007 and registration is now open. The minimum requirements for eligibility are:

• A Primary ABMS or AOA board certification
• An active license to practice medicine in the UnitedStates
  

ABIPP
Review Course Information

Physicians would miss out on the chance to see their Medicare payment cuts shaved by two percentage points next year under a Bush administration proposal that opts against using a special reserve fund to lessen the reimbursement hit. (AMANews)

The proposed Medicare payment rule issued July 2 by the Centers for Medicare Medicaid Services projects that next year's across-the-board physician cut will be 9.9%, the same as the previous estimate. The rule also announced for the first time that a $1.35 billion reserve fund Congress set aside last year to address physician payment and quality of care will not go toward decreasing that percentage.

AMA News

Electronic health records make little difference in the quality of medical care, at least when it comes to walk- in doctor visits, a new study found (Gardner, July 10, 2007 - HealthDay News).

"In clinic visits in which doctors did use and didn't use electronic health records, we didn't find clear evidence that EHR use was associated with better quality," said study lead author Dr. Jeffrey Linder.

A new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments - aimed at reigning in inflated drug product payments - was announced today in a final rule put on display at the Federal Register.

"This new payment formula allows Medicaid to pay more appropriately for prescription drugs dispensed to Medicaid beneficiaries," said Leslie V. Norwalk, Esq., acting administrator of the Centers for Medicare  Medicaid Services (CMS).

California has received more than 1,600 complaints from consumers, physicians and hospitals about Blue Cross of California since the state's largest health insurer was acquired by an Indiana firm in 2004, officials said Tuesday (Girion, July 11, 2007 - LA Times).

The state announced plans this week to hold a public hearing in Los Angeles on July 19 on how well Blue Cross has lived up to promises it made nearly three years ago as part of the $21-billion acquisition.

Interventional Techniques in Chronic Spinal Pain is the premier manual for interventional pain management physicians. This must have text book has an expected publication date of Summer 2007. All proceeds go to the American Society of Interventional Pain Physicians.

Pre-order your copy today!