CCH® Medicaid – April 1, 2009.

In November 2008, CMS issued the first changes in conditions for coverage for ambulatory surgical centers (ASCs) since 1982 (see ¶180,745). The new rules go into effect May 19, 2009. At the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues on March 24th, Claire Miley, of Bass Berry & Sims, in Nashville, highlighted some of the significant changes between the proposed rule issued in 2007 (see ¶220,555) and the final rule.

Under the proposed regulations, an ASC would not have remained certified as a Medicare ASC if it provided care that required patient monitoring that extended beyond midnight. CMS explained that a patient’s location at midnight is a generally accepted standard for determining his or her status as a hospital inpatient or a skilled nursing facility patient and as such, it is reasonable to apply the same standard in the ASC setting. In the final rule, CMS allows patients to remain in an ASC for 23 hours and 59 minutes, starting at the time of admission.

Read Full Article