On October 18th, the Centers for Medicare & Medicaid Services (CMS) released a final rule that removes its limitation on ASCs performing procedures on the day they are scheduled. ASCs will now be allowed to provide patient notifications on the day the procedure is performed, clearing the way for same-day surgeries.
 

The rule: 

• Removes the requirement that the notice of patient rights must be provided "in advance of the date of the procedure" and replaces it with the requirement that the notice must be provided "prior to the start of the surgical procedure."  This will allow ASCs to determine when they will provide these notices for all their patients as long as they are done prior to the surgical procedure being done. Particularly amends 416.50(a)(1) and other conditions.

• Removes the language of the previous exemption on this subject that provided for "emergency" notices being given on the day of surgery and outlining certain requirements that have to be met for the patient to qualify under the emergency criteria. Amends 416.50(h).

• Revises 416.50(d)(6) to add the patient's representative or the patient's surrogate to the parities that may be given written notice of a grievance decision.

 

This revision will take effect on December 23, 2011.

 

To download the complete rule change, click below.

Supporting Documents:
CMS Same Day Rule PDF

Updated Version of CMS Guidance for Surveyors: ASCs Released

 

CMS has published a new version of the State Operations Manual Appendix L – Guidance for Surveyors: Ambulatory Surgical Centers, which was updated May 13, 2011.

 

The changes are based on the Survey and Certification Memo issued December 17, 2010, titled “Clarifications to the ASC Interpretive Guidelines – Comprehensive Medical History & Physical (H&P) Assessment.” Among other revisions, a comprehensive H&P and surgery may now be performed on the same day.  

 

Please review the changes in the interpretive guidelines for 416.42(a)(1) (pages 59-60) and 416.52(a)(1) and (2) (pages 157, 158 and 160).

 

For your reference, the document is being provided with page numbers included.

Supporting Documents:
State Operations Manual - Appendix L ASCs 5-13-11

CMS has released a memo clarifying the use of same day H&P assessments.  Below is a summary of the memo.

 

·           Comprehensive H&P and Surgery may be performed on same day: As long as the H&P is performed by qualified personnel, is comprehensive, and is placed in the patient’s ASC medical record prior to surgery, it may be performed on the same day as the surgical procedure, including in the ASC.

 

·           Comprehensive H&P and some elements of the pre-surgical assessments may be conducted as one assessment: If the H&P is conducted in the ASC on the same day as the surgical procedure, then some elements of the required pre-surgical assessments may be incorporated into the H&P.

 

Click the link below to view the complete memo from CMS.

Supporting Documents:
CMS H&P Memo