2012 PPS Final Rule Implements Quality Reporting Program for ASCs

On November 30, 2011, the Centers for Medicare & Medicaid Services (CMS) published the final rule updating the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) payment system for Calendar Year (CY) 2012 (the CY 2012 OPPS/ASC Final Rule). Among other things, the CY 2012 OPPS/ASC Final Rule implements a new quality-measure reporting program for ASCs. CMS has adopted five quality measures for ASCs to report beginning October 1, 2012 for CY 2014 payment determination. Four of these are outcome measures and one a surgical infection-control measure. Also, as further discussed below, CMS is adding two structural measures for ASC reporting to begin during CY 2013 for CY 2015 payment determination, as well as one National Healthcare Safety Network (NHSN) infection-control measure for ASC reporting to begin during CY 2014 for CY 2016 payment determination. CMS also indicates that it will propose in the CY 2013 OPPS/ ASC proposed rule how payment penalties will be calculated for failure to report on these measures.

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