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Experience. Integrity. Advocacy.

ASCQR Program Updates

The Ambulatory Surgery Center Quality Reporting Program (ASCQR) requirements for 2014 to avoid a payment adjustment for 2016 include two new web-based measures. The data collection for those measures began on April 1, 2014, though the submission of that data is not required until 2015.

Measure ASC-9: “Endoscopy/Polyp Surveillance: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Patients” and Measure ASC-10: “Endoscopy/Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of Inappropriate Use” both require a medical record review of a selected sample of patients who meet denominator criteria. While the data collection period covers April 1, 2014, through December 31, 2014, since only a sample is required, the data can actually be collected at any time prior to reporting it during the submission period of January 1, 2015, through August 15, 2015.

The data collection periods for these measures originally covered the entire calendar year of 2014. Because of the government shut-down in the fall of 2013 and the delayed release of the Hospital Outpatient Prospective Payment System/Ambulatory Surgical Center Payment System (OPPS/ASC), however, the final rule mandating these measures was delayed as well as the collection periods themselves.

An additional measure, ASC-11: “Cataracts- Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery,” also was included in the original program guidelines for 2014. In April 2014, however, the Centers for Medicare and Medicaid Services (CMS) delayed the collection period for that measure until January 1, 2015, because of “operational difficulties with this specific measure.” Additional clarifications for this measure are expected in the upcoming CY 2015 OPPS/ASC proposed rule with comment period.

In addition to new measures ASC-9 and ASC-10, other measures for 2014 include the five claims-based measures (ASC-1 through ASC-5) which must be submitted for 50 percent of all Medicare Part B Fee-for-Service Claims, including for Medicare Railroad Retirement Board beneficiaries and Medicare Secondary Payer claims, as well as the three other web-based measures (ASC 6 through ASC 8) which must be submitted via the Quality Net Secure Portal or the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) during the specified submission period. No web-based measures are required to be submitted during the 2014 calendar year, though the submission period for ASC-8 is October 1, 2014, through March 31, 2015, and the submission period for all other 2014 web-based measures is January 1, 2015, through August 15, 2015.

ASCs with fewer than 240 Medicare claims (primary plus secondary payer) per year during a reporting period would not be required to participate in the ASCQR Program for the following reporting period and payment determination year. This includes all program requirements, both claims-based and web-based measures.

Submitting any quality measure data, however, either by including QDCs on at least one Medicare Part B facility claim or answering web-based measures, designates the ASC as participating in the ASCQR Program. To withdraw from the program, an ASC must submit a withdrawal form to CMS. Specific instructions on how to withdraw and the withdrawal form can be found on QualityNet.

For more information about specific measure specifications, timeline, or other details, visit the ASCQR Program page at Quality Net or register for the ASCQR program list serve. Also, Dr. Anita Bhatia, PhD, MPH, Government Task Leader for the ASCQR Program, will present a webinar at 10 a.m. and 2 p.m., Wednesday, July 23, describing potential changes to the ASCQR Program, reviewing the current requirements, and concluding with a question and answer session open to all participants. Register at www.oqrsupport.com/asc/education.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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