Healthcare legislation has the power to radically change the way ASCs are run. National and state-level policies regarding reimbursement, noncompetes and practice permissions have been top of mind for ASC leaders. Here is how legislators are tackling five issues:
1. Supervision requirements for certified registered nurse anesthetists. Government officials from Florida, Colorado, Delaware, Missouri and California are working to eliminate or loosen supervision requirements for certified registered nurse anesthetists. Florida lawmakers Rep. Mike Giallombardo and Sen. Blaise Ingoglia proposed legislation that would eliminate the current requirement for certified registered nurse anesthetists to have a written supervisory agreement with a physician.
U.S. Reps. Sam Graves of Missouri and Jared Huffman of California reintroduced the Save America's Rural Hospitals Act, which aims to expand the scope of practice for CRNAs, allowing them to work without physician supervision.
2. Banning noncompete agreements. New York Gov. Kathy Hochul is debating whether to sign a bill that would prohibit all noncompete agreements.
As written, the bill would apply to all workers regardless of compensation. Ms. Hochul said she wants to see a compensation cap for the ban, floating $250,000 as a level above which noncompetes would be allowed.
She said she intends to act on most legislation by the end of 2023. However, it is possible that a decision on the noncompete bill may not come until early February.
3. Increasing transparency of Medicare Advantage plans. U.S. Sens. Bill Cassidy, MD, Catherine Cortez Mastro, Elizabeth Warren and Marsha Blackburn have introduced bipartisan legislation designed to improve the transparency of Medicare Advantage plans.
The Encounter Data Enhancement Act would require Medicare Advantage plans to report how much they are actually paying for patient services and how much patients are responsible for paying out of pocket.
While the government already requires Medicare Advantage to report encounter data on services provided, the data is often incomplete and lacking key information. The Encounter Data Enhancement Act would help lawmakers conduct oversight of federal dollars going to Medicare Advantage plans, assess quality of care and strengthen healthcare access.
4. Burnout. Two pieces of legislation are in the pipeline in Congress that would attempt to reduce burnout among physicians and improve conditions to reduce existing provider shortages through annual payment updates to account for rising inflation, expanding prior authorization reforms that CMS finalized and allowing state legislatures to reform them to eliminate practice and administrative burdens.
5. Physician shortages. The Conrad State 30 and the Physician Access Reauthorization Act aims to ease physician shortages by expanding residency training options, providing greater student loan support and creating smooth pathways for foreign-trained physicians.