Keeping up with current Medicare certification and accreditation guidelines can seem like a constant race. Here are six CMS, Joint Commission and Accreditation Association for Ambulatory Health Care updates to make sure surgery centers stay ahead of the curve.
1. CMS officially ends bariatric surgery accreditation requirement. The Centers for Medicare and Medicaid Services have officially ruled that Medicare patients are no longer required to undergo bariatric surgery at an accredited facility. CMS originally issued a decision memo in July stating its intention to drop the requirement. CMS officials stated sufficient evidence had been found to support the elimination of the requirement. Health services researchers, led by John D. Birkmeyer, MD, initially requested the policy change.
The proposal was met with strong opposition from several medical societies. President-elect of the American Society for Metabolic and Bariatric Surgery Ninh T. Nguyen, MD, FACS, co-authored a study published in Surgical Endoscopy. The study found that non-accredited bariatric facilities had a mortality rate of 0.22 percent, while accredited facilities had a mortality rate of 0.6 percent.
The official ruling was made on Sept. 25. Groups including the Obesity Society, American Society of Metabolic and Bariatric Surgery, American College of Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, Academy of Nutrition and Dietetics, American Society of Bariatric Physicians and American Association of Clinical Endocrinologists all stand firm in their opposition of the ruling.
Though CMS has dropped the requirement, major insurers including Aetna, Blue Cross and Blue Shield, Cigna and United Healthcare still support bariatric procedures being performed in an accredited facility. The proposal does not change the number of bariatric procedures covered by Medicare.
2. CMS approves several life safety code waivers. CMS has granted waivers for multiple requirements in the 2000 edition of the Life Safety Code. The decision came after the Joint Commission petitioned CMS to grant the waivers as a way to lessen healthcare organizations' financial burden. The waivers are only granted when there is no negative effect on patient health and safety.
The waivers cover issues including suites, doors, openings in exit enclosures, extinguishing requirements, clean waste and patient record recycling containers, emergency generators and standby power systems and medical gas master alarms.
Ambulatory surgery centers, hospitals, critical access hospitals, long-term care facilities and inpatient hospices can all take advantage of the waivers. Healthcare providers do not need formal approval from CMS to act on the waivers.
3. CMS issues guidelines on Medicare survey policy after facility ownership changes. CMS has issued a reminder of its guidelines dictating protocol for Medicare certification of facilities that change ownership. Any owner of a facility that provides care for Medicare patients must inform CMS when considering the sale of the facility.
CMS has the right to automatically assign new facility owners Medicare certification. If automatic assignment is accepted no survey is required. Owners are able to reject automatic assignment, in which case the new owner is not liable for Medicare overpayments or underpayments. In the case of rejection, the facility's current Medicare provider agreement is terminated and the facility is considered a new applicant.
In order to once again obtain Medicare certification, surveys must be unannounced. CMS suggests that facilities accept automatic assignment.
Read the full document.
4. Joint Commission announces five most difficult ambulatory care standards. The Joint Commission has shared the five most challenging accreditation standards for ambulatory care in the first half of 2013. The five standards are the most frequent issues ambulatory care facilities are deemed to be not compliant with in the first half of this year.
1. 50 percent noncompliance: The organization grants, initial, renewed or revised clinical privileges to individuals who are permitted by law and the organization to practice independently (HR.02.01.03).
2. 38 percent noncompliance: The organization safely store medications (MM.03.01.01).
3. 37 percent noncompliance: The organization reduces the risk of infections associated with medical equipment, devices and supplies (IC.02.02.01)
4. 28 percent noncompliance: The organization identifies risks for acquiring and transmitting infections (IC.01.03.01).
5. 23 percent noncompliance: The organization safely manages high-alert and hazardous medications (MM.01.01.03).
The top four most challenging requirements were the same requirements deemed the most challenging in 2012. The fifth most challenging requirement in 2012 was EC.02.02.01, "The organization manages risks related to hazardous materials and waste," with a noncompliance rate of 18 percent.
5. AAHC public comment period on proposed revisions & existing standards open until Oct. 8. On Sept. 9, the Accreditation Association for Ambulatory Health Care opened a period of public comment on its existing standards and proposed revisions for 2014.
The revisions will apply to standards included in the Accreditation Handbook for Ambulatory Health Care, Accreditation Handbook for Ambulatory Care including Medicare Requirements for ASCs and Accreditation Handbook for Office-Based Surgery including Review Guidelines.
AAAHC encourages comment from the public, accredited organizations, medical specialty groups, surveyors, regulatory agencies and member group representatives. The comment period is open until Oct 8 at 5 p.m.
6. AAAHC accreditation standards available through software tools. AAAHC has announced that its accreditation standards are licensed for use in the software tools of Basha and Power DMS. Through this agreement, surgery center leaders are now able to electronically store information related to AAAHC standards, search for standards by keyword and use the tools to help ensure their centers are up-to-date and compliant will all standards and federal and state regulations.
The software company Bash offers the software system ASCpro. PowerDMS, a document management solutions company, offers a cloud-based application for storing data and checking compliance.
To be a complimentary reviewer at the 20th Annual Becker's ASC Meeting on Oct. 24 to 26 in Chicago, please also email Sbecker@beckershealthcare.com or call 18004172035. There are approximately five spots left to be reviewers.
More Articles on Accreditation:
The Power of the Checklist: 5 Steps for Surgery Centers to Always Be Accreditation Ready
AAAHC Accredits Robinwood Surgery Center in Maryland
Joint Commission Accredits MD Laser Surgery Center in Maryland
1. CMS officially ends bariatric surgery accreditation requirement. The Centers for Medicare and Medicaid Services have officially ruled that Medicare patients are no longer required to undergo bariatric surgery at an accredited facility. CMS originally issued a decision memo in July stating its intention to drop the requirement. CMS officials stated sufficient evidence had been found to support the elimination of the requirement. Health services researchers, led by John D. Birkmeyer, MD, initially requested the policy change.
The proposal was met with strong opposition from several medical societies. President-elect of the American Society for Metabolic and Bariatric Surgery Ninh T. Nguyen, MD, FACS, co-authored a study published in Surgical Endoscopy. The study found that non-accredited bariatric facilities had a mortality rate of 0.22 percent, while accredited facilities had a mortality rate of 0.6 percent.
The official ruling was made on Sept. 25. Groups including the Obesity Society, American Society of Metabolic and Bariatric Surgery, American College of Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, Academy of Nutrition and Dietetics, American Society of Bariatric Physicians and American Association of Clinical Endocrinologists all stand firm in their opposition of the ruling.
Though CMS has dropped the requirement, major insurers including Aetna, Blue Cross and Blue Shield, Cigna and United Healthcare still support bariatric procedures being performed in an accredited facility. The proposal does not change the number of bariatric procedures covered by Medicare.
2. CMS approves several life safety code waivers. CMS has granted waivers for multiple requirements in the 2000 edition of the Life Safety Code. The decision came after the Joint Commission petitioned CMS to grant the waivers as a way to lessen healthcare organizations' financial burden. The waivers are only granted when there is no negative effect on patient health and safety.
The waivers cover issues including suites, doors, openings in exit enclosures, extinguishing requirements, clean waste and patient record recycling containers, emergency generators and standby power systems and medical gas master alarms.
Ambulatory surgery centers, hospitals, critical access hospitals, long-term care facilities and inpatient hospices can all take advantage of the waivers. Healthcare providers do not need formal approval from CMS to act on the waivers.
3. CMS issues guidelines on Medicare survey policy after facility ownership changes. CMS has issued a reminder of its guidelines dictating protocol for Medicare certification of facilities that change ownership. Any owner of a facility that provides care for Medicare patients must inform CMS when considering the sale of the facility.
CMS has the right to automatically assign new facility owners Medicare certification. If automatic assignment is accepted no survey is required. Owners are able to reject automatic assignment, in which case the new owner is not liable for Medicare overpayments or underpayments. In the case of rejection, the facility's current Medicare provider agreement is terminated and the facility is considered a new applicant.
In order to once again obtain Medicare certification, surveys must be unannounced. CMS suggests that facilities accept automatic assignment.
Read the full document.
4. Joint Commission announces five most difficult ambulatory care standards. The Joint Commission has shared the five most challenging accreditation standards for ambulatory care in the first half of 2013. The five standards are the most frequent issues ambulatory care facilities are deemed to be not compliant with in the first half of this year.
1. 50 percent noncompliance: The organization grants, initial, renewed or revised clinical privileges to individuals who are permitted by law and the organization to practice independently (HR.02.01.03).
2. 38 percent noncompliance: The organization safely store medications (MM.03.01.01).
3. 37 percent noncompliance: The organization reduces the risk of infections associated with medical equipment, devices and supplies (IC.02.02.01)
4. 28 percent noncompliance: The organization identifies risks for acquiring and transmitting infections (IC.01.03.01).
5. 23 percent noncompliance: The organization safely manages high-alert and hazardous medications (MM.01.01.03).
The top four most challenging requirements were the same requirements deemed the most challenging in 2012. The fifth most challenging requirement in 2012 was EC.02.02.01, "The organization manages risks related to hazardous materials and waste," with a noncompliance rate of 18 percent.
5. AAHC public comment period on proposed revisions & existing standards open until Oct. 8. On Sept. 9, the Accreditation Association for Ambulatory Health Care opened a period of public comment on its existing standards and proposed revisions for 2014.
The revisions will apply to standards included in the Accreditation Handbook for Ambulatory Health Care, Accreditation Handbook for Ambulatory Care including Medicare Requirements for ASCs and Accreditation Handbook for Office-Based Surgery including Review Guidelines.
AAAHC encourages comment from the public, accredited organizations, medical specialty groups, surveyors, regulatory agencies and member group representatives. The comment period is open until Oct 8 at 5 p.m.
6. AAAHC accreditation standards available through software tools. AAAHC has announced that its accreditation standards are licensed for use in the software tools of Basha and Power DMS. Through this agreement, surgery center leaders are now able to electronically store information related to AAAHC standards, search for standards by keyword and use the tools to help ensure their centers are up-to-date and compliant will all standards and federal and state regulations.
The software company Bash offers the software system ASCpro. PowerDMS, a document management solutions company, offers a cloud-based application for storing data and checking compliance.
To be a complimentary reviewer at the 20th Annual Becker's ASC Meeting on Oct. 24 to 26 in Chicago, please also email Sbecker@beckershealthcare.com or call 18004172035. There are approximately five spots left to be reviewers.
More Articles on Accreditation:
The Power of the Checklist: 5 Steps for Surgery Centers to Always Be Accreditation Ready
AAAHC Accredits Robinwood Surgery Center in Maryland
Joint Commission Accredits MD Laser Surgery Center in Maryland