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Medicare Bill Gives Outpatient Surgery a Reprieve
OSD Staff
Publish Date: June 9, 2008   |  Tags:   News
Medicare Bill Gives Outpatient Surgery a Reprieve
On December 15, Congress approved a package of Medicare provisions that will restore approximately $35 billion in reimbursement cuts imposed by the Balanced Budget Act of 1997. The bill, termed the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), includes a provision that may substantially benefit ambulatory surgery centers.

The bill does three things for ambulatory surgery centers:

  • It requires the Health Care Financing Administration to postpone implementing the ASC rates that they first proposed in June 1998 until January 2002.

  • It mandates that HCFA will implement rebased rates over a four-year period. In the first year of the phase-in period, facilities will be paid 25 percent of the new rate and 75 percent of the old rate; the next year, the rate will be 50 percent of the new rate and 50 percent of the old rate, and so on.

  • It requires HCFA to begin implementing rates based on a more current survey of facility costs in January 2003.

What this probably means is that the rates proposed in June 1998 will never go into effect, according to Eric Zimmerman, who is counsel to the American Association of Ambulatory Surgery Centers. Mr. Zimmerman practices at McDermott, Will