Chairman Herger Asks HHS to Investigate Medicare Savings in the ASC Setting
Chairman Wally Herger (R-2nd-CA) from the House Ways and Means Health Subcommittee sent a letter today to the Office of the Inspector General (OIG) of the Department of Health and Human Services asking the OIG to analyze the impact on Medicare spending when procedures occur in the ASC setting.
Chairman Herger cites a 2003 report that found that Medicare paid $1.1 billion more for services in 1999 because they were provided in the hospital outpatient department (HOPD) setting instead of an ASC. Medicare-certified ASCs are paid at a reduced rate for the same service that is performed in an HOPD, and over time ASC payment rates have continued to diverge further from that of HOPDs. The ASC Industry has a longstanding commitment to high-quality, low-cost services, and many policymakers believe that ASCs provide a safe and less costly alternative to the HOPD setting.
The Chairman has requested that the OIG examine quality and payment differences between the ASC and HOPD settings, and identify potential policy changes that could facilitate Medicare beneficiaries receiving their outpatient surgery in the most appropriate and cost-effective setting.
To view the full letter, click here.
