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Posts Tagged ‘Ambulatory Surgery Center’

Ambulatory Surgery Center National Legal Practice ASC Compliance Issues

Monday, January 30th, 2017

Ambulatory Surgery Center Compliance Legal Practice

Ruder Ware has developed an active practice counseling ambulatory surgery center providers and has served as special counsel in several cases involving ambulatory surgery center exclusions.  The firm’s health care and compliance attorneys are knowledgeable on the numerous legal and regulatory requirements that are applicable to ASCs.  The regulations applicable to these entities are complex and nuanced.  The consequences of failing to comply or with taking improper steps to exclude providers can be very costly.

Some of the issues that our health care practice has recently addressed include the following:

  • Counseling ASC’s on the application of the Stark law, Anti-Kickback Statute, and ASC safe harbor issues.
  • Advising and representing providers on issues relating to conditions of participation and governmental surveys.
  • Representing organizations in preparing and submitting self-disclosure to the government.
  • Development of ASC investment entities.
  • Establishment of ASC compliance programs
  • Decisions regarding exclusion of “under-performing” providers.
  • Structuring exclusion provisions to minimize risk of violating regulations or enhancing the risk of litigation.
  • Sale and purchase of surgery centers.
  • ASC licensure and governmental approval.
  • Compliance with patient confidentiality and privacy laws.
  • Risk assessment, audits, compliance work plans, staff compliance training.
  • Contractual relationships with outside parties.

Ambulatory Surgery Center Lawyers – Ambulatory Surgery Center Lawyers

Ambulatory Surgery Center Attorney

John H. Fisher has practiced health care law for over 25 years.  One of John’s significant areas of expertise involves the regulatory and business aspects of ambulatory surgery centers.  Over the years, John has represented numerous clients on legal and compliance issues related to ambulatory surgery centers.  John consults as a subject matter expert and provider legal backup to other attorneys and law firms from around the country on issues relating to ambulatory surgery centers.  Some of John’s more recent ASC related projects include:

  •  Representation of an ASC in connection with the exclusion of non-complying owners.
  • Representation of excluded providers in litigation and settlement.
  • Creating operating documents that comply with ambulatory surgery center safe harbors and other applicable regulatory requirements.
  • Creation of policies and procedures required to gain certification as an ASC.
  • Consultation with local litigation attorneys regarding regulatory issues relevant to ASC litigation.
  • Consultation with ASCs on establishment of compliance programs and identification of related risk areas.
  • Assisting ASC providers in addressing detected deviations in operating and compliance requirements.

Ambulatory Sugery Center Radiologist Rules – Proposed Simplified By CMS

Friday, February 15th, 2013

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.

2013 Ambulatory Surgery Center Rates Proposes By CMS

Tuesday, July 17th, 2012

CMS Increases Ambulatory Surgery Center Rates, Adds 16 New Procedures for 2013

Ambulatory surgery centers will receive an across-the-board 1.3% rate increase under the 2013 propose Medicare ASC rates. The proposed rate adjustments were released by the Center for Medicare and Medicaid services on July 12, 2012.

CMS has also proposed the addition of 16 new procedures to the list of procedures that are payable in an ambulatory surgery center beginning January 1, 2013.

View the proposed rate changes on the CMS site.  Ambulatory Surgery Center Rates 2013

John H. Fisher

Health Care Counsel
Ruder Ware, L.L.S.C.
500 First Street, Suite 8000
P.O. Box 8050
Wausau, WI 54402-8050

Tel 715.845.4336
Fax 715.845.2718

Ruder Ware is a member of Meritas Law Firms Worldwide

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