GOVERNMENT & MEDICINE

Support builds to protect ambulatory surgery center coverage

The Senate Finance Committee chief says eliminating Medicare pay for some procedures at the facilities could hurt rural patients' access to care.

By David Glendinning, AMNews staff. May 2, 2005.

Washington -- A move to preserve the number of procedures covered by Medicare that physicians can perform at ambulatory surgery centers has won some key congressional backing.

Senate Finance Committee Chair Charles Grassley (R, Iowa) expressed concern over the Centers for Medicare & Medicaid Services' proposed plan to remove 100 services, such as prostate biopsies, from the list of covered treatments that can be performed at the centers. Forcing doctors to conduct the procedures in their offices or refer patients to hospital outpatient departments could interfere with a proven care alternative, he wrote in a letter to CMS Administrator Mark McClellan, MD, PhD.

"I am concerned that the recent proposed rule suggests deleting a number of procedures that should not be deleted as long as the procedure can be performed in an ASC setting at the same or greater level of safety as compared to an outpatient setting," Grassley wrote. "Preventing ASCs from performing certain procedures in an ASC setting may affect access to care, especially in rural areas where an ASC is more convenient than an outpatient facility."

The move came as CMS worked to finalize the proposed rule. As of press time, the agency planned to maintain its original timeline by rolling out the final regulation this spring in advance of a July 1 effective date. The rule would allow the surgical centers to charge Medicare for 25 other procedures that are currently not covered -- a change that would be welcome to the facilities and physicians.

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