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When the Centers for Medicare and Medicaid (CMS) announced its new name and acronym, I commented that neither the public's view of the agency nor the agency itself would change simply because it had a new acronym. I added that if it was truly the same old agency, CMS perhaps could stand for Center for Mangled Simplicity. But since its name change, CMS has undertaken many efforts on which it could be judged. As a representative of the ASC industry, I suggest that CMS deserves a ?B' for improvement. Here's why.

• Announced ASC rate increases in a timely fashion. This year, the announcement of the annual ASC rate increase occurred in time for many, if not most, carriers to implement the increase by Oct. 1, 2002, as provided in the law. Some might question a ?B' grade for a routine task that isn't completed on time. This is a valid point, but I believe that the agency's improvement with the timeliness of its updates in each of the last two years deserves recognition. I hope that next year it can be announced early enough that all carriers will start paying the new rates on their effective date.
• Updated reimbursable procedures. Despite a mandate to update the list of procedures for which Medicare reimburses ASCs every two years, CMS has not updated this list since 1995. But it now appears likely that this update will occur sometime in 2003. FASA is hopeful that CMS will begin working on the next update as soon as the current update is published.
• Addressed ASC Medicare rates. Finally, although CMS has not succeeded in regular recalculation of the costs of providing ASC services as mandated in the law, it recognizes its failures and is looking for alternative mechanisms for establishing ASC rates. FASA is delighted to see an evaluation of the mechanism used for setting ASC rates and the reasonableness of the resulting rates. Whether the best approach will be implementing a new system or identifying a way to implement the existing system on a timely and accurate basis remains to be seen.

The fact that CMS has involved the industry in assessing ASC rates is extremely positive. These discussions are at the preliminary stage and no changes will be made without extensive industry analysis and discussion. It may well be that the best approach is the current mechanism - conducting surveys of the ASCs' cost and regular rebasing of rates based on these surveys - but done on a timely basis.

Admitting problems and attempting to rectify them are positive actions that government agencies don't always take, but CMS has done this. Most of these positive developments were spearheaded primarily by CMS employees that were in place even before the first Bush administration. So on behalf of the ASC industry, I say thank you, CMS, for paying some attention to the ASC community.

Kathy Bryant ([email protected]) is the executive director of the Federated Ambulatory Surgery Association.