From: Scott Tenner [Scott.Tenner@downstate.edu]

Sent: Monday, July 07, 2008 9:11 AM

To: DrTenner@BrooklynGI.com

Subject: Regarding CMS and ASCs

CMS Wants To Increase Funding For ASC Surveys
In response to a Hepatitis C outbreak in Nevada earlier this year, CMS hopes to make additional resources available to expand the size of the sample group of Ambulatory Surgical Centers (ASCs) involved in its Tier 2 survey.

CMS makes the statement in a May letter to State Survey Agencies that also outlines a series of “safe injection practices” that ACS must establish in order to prevent infections, maintain a sanitary environment, and report results to the proper authorities.

The agency asks SSAs to disseminate the letter to every ASC in its state.
Asked about the funding, a CMS official explains that as of May 1 there are 5,027 ASCs, out of which 1,150 are accredited and 3,877 are not. “We also expect about 100 additional new ASCs this year,” the official says.

The aggregate cost of increasing the sample size from 5 percent of all 3,877 non-accredited ASCs to 10 percent is about $700,000, the source says. “Whether such as expansion is feasible will depend on whether Congress appropriates funds for the President's full FY 2009 budget request for Medicare survey and certification functions,” the administration official says.

In each of the past four fiscal years, the president's budget has include funds to increase the frequency of ASC surveys. But, Congress has not fully funded the request and, as a result, the “frequency of ASC on-site surveys averages about once every 10 years, much less than CMS' policy goal of at least once every six years,” the source says.

To partially compensate for the lack of ability to survey all ASCs “with the frequency we desire,” CMS says it added a 5 percent sample of ASCs for target surveys and made these a higher, or Tier II, priority, to help SSAs focus on ASCs that “may need greater oversight compared to others.” CMS also adopted the approach for other provider types, such as dialysis facilities and home health agencies.

- Scott

Scott Tenner, M.D., M.P.H.
Director, Medical Education and Research
Division of Gastroenterology
Maimonides Medical Center
Associate Professor of Medicine,
State University of New York - Health Sciences Center
2211 Emmons Ave
Brooklyn, NY 11235
718-368-2960
718-368-2249 Fax
DrTenner@BrooklynGI.com