On October 1, 2012, the Centers for Medicare & Medicaid Services (CMS) is introducing a new quality reporting program that will require ASCs to report data on several quality measures or face reductions in their future Medicare payments. ASCA has released a free toolkit to help ASCs succeed in meeting the program’s requirements.
The materials in ASCA’s quality reporting toolkit, which is sponsored by GHN Online and McKesson, include:
· a timeline of important dates and events;
· a list of the quality data G-codes ASCs will need to use to report certain data;
· a list of frequently asked questions;
· required safe surgery checklist information; and
· a sample CMS-1500 claim form that shows where ASCs will be submitting most of their quality data reports.
ASCA is also mailing free print copies of these materials to all Medicare-certified ASCs. Those kits should arrive in late August/early September.
CMS intends to make these quality reports public, and results that demonstrate the high-quality care that ASCs provide would strengthen the ASC community’s track record of quality care and superior patient outcomes. Positive results could also lead to escalating levels of confidence among the patients and physicians who rely on ASCs.
Reporting requirements that begin October 1, 2012, will require at least 50 percent of an ASC’s Medicare claims to contain quality data G-codes. Those codes will indicate whether or not a patient had a burn, a fall, a wrong site/side/patient/procedure/implant event, a hospital transfer and on-time prophylactic IV antibiotics at the ASC. If a facility fails to meet that requirement, CMS will reduce the ASC conversion factor for that center by 2 percent in 2014, causing all of the ASC’s Medicare claims to be paid at a lower rate. Failure to report in subsequent years will affect future years’ payments to the same extent.
Additional reporting requirements are already in place for 2013—some based on 2012 data that ASCs can collect now. More reporting requirements are expected in the future.