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Proposed New Medicare ASC Rules

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule, dated August 24, 2007, revising requirements for ambulatory surgery centers (ASCs) to bill for services provided to Medicare beneficiaries. This proposed rule is separate from the new payment system ruling scheduled for a January 2008 implementation.

The proposed rule (CMS 3887-P) updates conditions for Medicare coverage. CMS expects an increased volume of services provided in ASCs and believes that quality standards are not adequate. The proposed update focuses on quality assessments for ASCs and patient protection.

Of particular interest in the proposed rule is the admission and pre-surgical assessment standard. It states: Patient must have a comprehensive medical history and physical assessment completed not more than 30 days before the date of scheduled surgery by a physician or other qualified practitioner in accordance with State law and ASC policy. To ensure the ASC healthcare team would have all patient information available if needed, the ASC would be required to place the medical history and physical assessment in the patients medical record before the surgical procedure is started.

This proposal of the 30-day time limit for a medical history and physical assessment is consistent with hospitals condition of participation.

The complete proposed rule can be found at http://www.cms.hhs.gov/CFCsAndCoPs/Downloads/ambsurgreg.pdf.

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