HR 6138 - ASC Payment Transparency Act of 2018 Passes House

American Society of Interventional Pain Physicians (ASIPP) and the Society of Interventional Pain Management Surgery Centers (SIPMS) are pleased to announce the successful passage of HR 6138 - ASC Payment Transparency Act of 2018 on 7/25/2018 in the House of Representatives. Due to nonrepresentation of pain physicians on many committees, including those of surgery centers on HOP Commission, ASIPP and SIPMS have worked with Congress. HR 6138 was sponsored by Congressman Devin Nunes (R-CA) and House Ways and Means Committee Chairman Kevin Brady (R-TX) over the past few years to support the bill. Specifically, ASIPP and SIPMS have regularly requested the congressional action to require the outside advisory panel that reviews the Medicare Prospective Payment System for hospital outpatient department services to include at least one ambulatory surgery center (ASC) representative. Representatives from ASIPP and SIPMS had several meetings with the House Ways and Means Committee staff during the past 3 years.

Here is the substance of HR 6138:

1.   H.R. 6138 requires CMS to specify the criteria it uses to exclude certain ASC-based surgical procedures from Medicare coverage.

2.   The bill also stipulates CMS can't exclude a procedure because of a general concern. The procedure can only be reported using an unlisted surgical procedure code.

3.  The bill also includes that at least one ASC representative would have to be included on the 15-member advisory panel that reviews the Medicare prospective payment system for hospital outpatient departments and ASCs. The law currently requires all members to be hospital- or health system-employed.

Now the bill has to go to the senate and after passage has to be signed by the President to become law.