CMS and Philadelphia-based Wills Eye Hospital are at odds over the agency classifying Wills Eye as an ASC, according to Philly.com.
Here are five key points:
1. Wills Eye re-established inpatient care services at its main building in 2013 and then applied for Medicare enrollment as a hospital. Prior to adding these serves, the eye center fell under ASC classification.
2. Following its application, the eye center relinquished its state ASC license. However, CMS denied the application saying most of Wills Eye's primary services were outpatient.
3. Wills Eyes filed a complaint on Dec. 23, 2016, saying CMS made the decision randomly and if CMS made the decision for other facilities in the future, many high-profile hospitals will forgo Medicare participation.
4. A CMS official previously estimated 17 percent of Wills Eye's cases were inpatient, at most, making the percent too low for the facility to quality as a hospital. Wills Eyes countered the claim using American Hospital Association data that showed four major hospitals that had inpatient ratios of less than 2 percent in fiscal year 2011.
5. Pennsylvania Department of Health, which licensed Wills Eyes as a hospital, had officials advocating on Wills Eye's behalf. However, an administrative law judge ruled against the facility in February 2016 and another judge ruled against the facility in October 2016.