Indiana Federation of Ambulatory Surgery Centers

There are several other issues to consider regarding the classification of operating rooms. The complete Guidelines for Design and Construction of Hospital and Health Care Facilities, 2001 edition can be obtained from the AIA by calling 1-800-365-2724.

The Indiana State Department of Health just added a consumer reports page to their website. This page includes reports of the last three state licensure survey results and other information on ambulatory surgery centers in Indiana. Click here to go to page

Posted October 20, 2005
IFASC Executive Director Carol Blanar recently contacted Tom Reed, Public Health
Administrator, regarding the information sheet sent to ASCs for review. This sheet erroneously lists some accredited ASCs as not being accredited. Mr. Reed responded by saying, "We requested and still need a copy of the Letter or Certificate from the Accreditation Organization." He also said that a facility can fax a copy of the letter
to the state at 317/233-7157. Once the information is received, it "will appear in the individual consumer report two weeks after data entry." Mr. Reed concluded his
response by saying that they have received many letters from accreditation organizations.

In January 2006, the Indiana State Dept. of Health will have an ASC Consumer Report Available on their web site (www.statehealth.IN.gov) It will mirror the hospital Consumer Rept currently available. The serious events reported by the ASC will be listed on this report along with deficiencies noted at time of survey.

The Center for Medicare and Medicaid Services (CMS) will publish this week an interim-final regulation that restores to the ASC procedures list 95 of the 100 services that were proposed for deletion late last year.

Procedure Manual Available for Training Ambulatory Surgery Center Staff for Malignant Hyperthermia Crisis

(Sherburne, NY) - The Malignant Hyperthermia Association of the United States (MHAUS) has announced the availability of its Malignant Hyperthermia (MH) Procedure Manual for the Ambulatory Surgery Center. The manual organizes and prepares the ASC staff with the latest treatment methods for an MH crisis.

MH is a metabolic crisis precipitated by triggering general anesthetics in susceptible individuals. Because MH can result in morbidity and mortality, minutes count in its management.

"By having a plan for coordinated emergency response to the malignant hyperthermia crisis, the time from diagnosis to control of the syndrome is significantly shortened," says Henry Rosenberg, MD, the president of MHAUS. In dealing with MH every minute counts in reducing the chance of patient injury or death."

That plan is exactly what the procedure manual will accomplish for you and your colleagues in the ASC setting, in order to minimize the risk associated with malignant hyperthermia. The manual:

An instructional video, which enacts the response plan, accompanies the manual, all packaged in a durable, 3-ring binder. The MH Procedure Manual is also available in versions for hospital or office surgical settings.

For more information on the MH procedure manuals, contact MHAUS at (607)674-7901, PO Box 1069, Sherburne NY 13460, or www.mhaus.org.

The Malignant Hyperthermia Association of the United States has spent more than 20 years saving lives by providing MH educational services. It is dedicated to reducing the morbidity and mortality from MH and improving scientific understanding. Basic services include the MH Hotline, which provides access 24/7 to anesthesiologists specializing in MH-crisis management, a quarterly newsletter with the most recent info on MH, its Web site, www.mhaus.org, a valuable information resource, a treatment poster and other educational tools.

The Medicare Payment Advisory Commission (MedPAC) issued two reports, both assembled by RAND, which are of great potential interest to the ambulatory surgery center community. The studies compare patient characteristics for several procedures across various ambulatory settings, cataract surgery, colonoscopy, and MRI of head, neck and brain in hospitals and ambulatory surgery centers. Click here for AAASC review.

In May of 2004, the Indiana State Department of Health sent all Indiana ASCs a copy of "Advance Directives: Your Right to Decide". In response to this, Carol Blanar, President of IFASC, contacted Randy Snyder from the IN State Department of Health and inquired about whether ASCs should hand a copy of the document to all patients. To see his response, click here.

In a June 16, 2004 letter to all members of Congress, AAASC President David Shapiro, MD identified the favorable MedPAC recommendation to eliminate the restrictive Medicare Procedure list and thus save Medicare and beneficiaries millions of dollars annually and provide broader choice to beneficiaries.

In May, 2004 AAASC surveyed state ASC associations to identify the most pressing legislative and regulatory issues impacting the growth of ASC. Here are the top issues:

Workers Comp payment reductions
Restrictions on physician ownership
Public reporting of ASC financial information
CON changes that restrict ASC growth

For more information about a specific state, review the information on state association websites or contact the leadership of the state association available at the AAASC website: http://www.aaasc.org/state/

AAASC has placed emphasis on the development and support of strong state ASC associations for many years. The state association is the first line of defense for state level issues. Fortunately many state associations are well positioned organizationally and are doing a great job representing the ASC industry as state legislative and regulatory issues arise.

This guide is intended to provide the ASC community with basic information about how to influence the government policies that affect our businesses and our patients.

The American Hospital Association (AHA) issued a new policy paper during their meetings on Capitol Hill in Washington D.C. that “niche providers” are “undercutting the ability of community hospitals to continue to meet the needs of the broader community”. AHA includes ambulatory surgery centers as a niche provider.

AAASC President David Shapiro traveled to Washington , DC on April 8 for two important meetings with government study groups evaluating the Medicare ASC program. Dr. Shapiro was joined by AAASC Executive Director, Craig Jeffries, and Washington Counsel, Michael Romansky and Eric Zimmerman.

CMS Issues Memo on Overnight Stays

In a March 11 memorandum to state survey agency directors, CMS appears to be changing longstanding policy regarding overnight stays in ambulatory surgery centers. AAASC Washington Counsel has been in communication with CMS. CMS understands the questions we have raised about the statements in their memo that appear to restrict Medicare certified centers to performing only Medicare approved procedures. CMS is actively considering the need to correct the unintended change and we will notify members of their resolution.

CMS Issues Guidance on Specialty Hospital Moratorium

The Centers for Medicare & Medicaid Services announced details of its plan to implement a moratorium on physician investment in and referrals to certain specialty hospitals. Learn More

Medicare Payment Rates for ASC Services to be Dropped to pre-Oct.1, 03 Levels

Effective April 1, 2004, payment rates for the nine procedure groups will be as follows: Group 1 - $333,Group 2 - $446,Group 3 - $510, Group 4 - $630, Group 5 - $717, Group 6 - $676 plus $150 for IOL, Group 7 - $995, Group 8 - $823 plus $150 for IOL, Group 9 -$1,339 Please note that the rates listed above are national rates, and that actual payment rates will vary depending on your geographic location.
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The Medicare Payment Advisory Commission (MedPAC) approved three recommendations concerning Medicare payment to ambulatory surgery centers (ASCs) including two that were supported by AAASC.