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Ambulatory Sugery Center Radiologist Rules – Proposed Simplified By CMS

CMS Proposed Rule Would Simplify Ambulatory Surgery Center Radiologist Requirements 

Merging Physician Specialty PracticesOn February 7, 2013, the Center for Medicare/Medicaid Services (“CMS”) released a proposed rule that contains regulatory provisions to promote program efficiency, transparency and burden reduction.  The proposed rule proposes reforming certain Medicare regulations that CMS has identified as unnecessary, obsolete or excessively burdensome on health care providers and suppliers. 

One significant rule that CMS is proposing be abandoned is the requirement that Ambulatory Surgery Centers (“ASC”) meet the full hospital requirements for radiology services.  The full requirement must correctly be met by ASCs even though ASCs are only permitted to provide radiologic services that are integral to the performance of surgical services provided at the ASC. 

CMS concluded in the proposed regulations that some of the hospital conditions of participation requirements which are applicable to ASCs are unduly burdensome and create unnecessary costs.  Particularly, this CMS is proposing that the requirement to have a radiologist supervise the provision of radiologic services be deleted from the ASC conditions of participation.  CMS states that the requirement was overly aggressive since ASCs did not provide radiologic services that are required for interpretation or diagnosis.  CMS cites the cost of privileging radiologists and paying radiologist fees for oversight of radiology studies that are limited to services that are integral to surgical procedure.

The proposed revision would keep the governing body of the ASC responsible for determining if there are any procedures being performed at the ASC, which would require review by a radiologist.  The surgeon performing the procedure would be expected to be privileged and trained the use of imaging as an integral part of the procedure.  However, the use of radiology in connection with surgical procedures does not require the services of a radiologist in most cases.

The revised requirements would permit supervision of radiologic services used in an ASC by a doctor of medicine or osteopathy who is not a radiologist but is a general member of the ASC’s medical staff.  CMS welcomes comments on these proposed regulations.

The Ruder Ware Health Care Industry Focus Group has done a great deal of work structuring Ambulatory Surgery Centers to comply with regulatory requirements.  Please feel free to contact us with any questions regarding the structure or operation of your Ambulatory Surgery Center.

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John H. Fisher

Health Care Counsel
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