PROPOSED RULE RELEASED
2020 ASC Conversion Factor Projected at $47.827 for
ASCs Meeting Quality Reporting Requirements
On Monday, July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Policy Changes and Payment Rates proposed rule. The rule has a 60-day comment period, and ASCRS will be providing comments. CMS also released a fact sheet and press release on this proposed rule.
ASC Conversion Factor
For CY 2020, CMS proposes to adjust the CY 2019 ASC conversion factor ($46.532) by the wage adjustment budget neutrality factor of 1.0008 in addition to the MFP-adjusted hospital market basket update factor of 2.7%, which results in a proposed CY 2020 ASC conversion factor of $47.827 for ASCs meeting the quality reporting requirements.
For ASCs not meeting the quality reporting requirements, CMS is proposing to adjust the CY 2019 ASC conversion factor ($46.532) by the wage adjustment for budget neutrality factor of 1.0008 in addition to the quality reporting/MFP-adjusted hospital market basket update factor of 0.7%, which results in a proposed CY 2020 ASC conversion factor of $46.895 for ASCs not meeting the quality reporting requirements.
ASC Center Quality Reporting (ASCQR) Program
The ASCQR Program is a pay-for-reporting quality program for the ASC setting. The ASCQR Program requires ASCs to meet quality reporting requirements or receive a reduction of 2.0 percentage points in their annual fee schedule update if these requirements are not met.
CMS is not proposing to remove any measures in this rulemaking as the agency's analysis of the current ASCQR Program measure set indicates that there are no measures that meet the measure removal factors following last year’s comprehensive removal initiative. CMS is proposing to adopt one claims-based measure beginning with the CY 2024 payment determination, ASC-19: Facility-Level 7-Day Hospital Visits after General Surgery Procedures Performed at Ambulatory Surgical Centers (NQF #3357).
Additional information will be detailed in upcoming editions of Washington Watch Weekly. For questions, please contact Allison Madson, manager of regulatory affairs, at 703-591-2220 or firstname.lastname@example.org.