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Medicare is Missing a Way to Save the Trust Fund Money Unnecessary...

A way to save Medicare millions of dollars is being overlooked. The lack of cooperation between the nation's8217;s Hospitals and Ambulatory Surgery Centers (ASC) over transfer agreements is robbing the Medicare system. (fasa.org)



Ambulatory Surgery Centers (ASC) are required to have a transfer agreement with a hospital. However a hospital does not have to cooperate and a nursing home is only required to make a 's8220;good faith's8221; effort to get a hospital transfer agreement. The disparity is robbing the Medicare system.



On May 2, trustees for Medicare reported that the program will exhaust its funds just 12 years from now. Elimination of this unnecessary obligation for a transfer agreement or requiring additional collaboration from hospitals would have a financial impact on the trust fund.



In a recent letter to Center for Medicare and Medicaid Services (CMS) Administrator Mark McClellan, MD, PhD, Iowa Senator Charles E. Grassley, Chairman of the Senate Finance Committee, wrote that procedures being done at the nation's8217;s Ambulatory Surgical Centers (ASCs) 's8220;would greatly reduce overall Medicare spending.



Chairman Grassley'ss comments on Medicare spending come on the heels of a recently released study by The Moran Company. The Washington based health care research firm found on average, claims cost Medicare $320 more in a hospital outpatient department than in an ASC.



Despite this, one of the biggest obstacles to saving Medicare money is the transfer relationship required between hospitals and ASCs.

Medicare Regulation 'sect;416.41 states 's8220; The ASC must have an effective procedure for the immediate transfer to a hospital, of patients requiring emergency medical care beyond the capabilities of the ASC.'s8221;



Many believe that the Emergency Medical Treatment and Labor Act (EMTALA) makes these transfer agreements obsolete. This issue is dramatically impacting the ability of ASCs to do business across the country. The cost to Medicare is staggering.



This spring two Missouri lawmakers prepared legislation that would drop the transfer agreement requirement. Rep. Robert Schaaf, told the Associated Press he believes hospitals are trying to stifle competition. Hospitals claim that surgery centers are eating into their patient base, Schaaf said. The point is, it'ss not their patient base. It'ss every competitors's patient base. It is in the public'ss best interest to have more competition in health care, not less.



Meanwhile, the nation's8217;s nursing homes are required to have a transfer agreement but only a good faith effort is required to obtain a transfer agreement.



Medicare Regulation Section 483.75

's8220;(n) Transfer agreement (1) In accordance with section 1861(1) of the Act, the facility (other than a nursing facility located in a State on an Indian reservation) must have in effect a written transfer agreement with one or more hospitals approved for participation under the Medicare and Medicaid programs that..(2) The facility is considered to have a transfer agreement in effect if the facility has attempted in good faith to enter into an agreement with a hospital sufficiently close to the facility to make transfer feasible.'s8221;



The simple addition of the statement 's8220;the facility is considered to have a transfer agreement in effect if the facility has attempted in good faith to enter into an agreement with a hospital's8221; to the Medicare regulation for ASCs, would fix a significant problem these facilities across the nation are facing and have a significant impact on the financial stability of the Medicare trust fund.



Today, seventy percent of all surgeries in America are outpatient. However, only one out of every five of these is performed at an ASC. ASCs throughout the country have outstanding patient safety records while achieving high rates of efficiency and customer satisfaction.

There are more than 4 million surgical procedures performed annually, the business generated by the freestanding surgery centers represents a significant portion of the healthcare dollar and significant cost saving to Medicare.

    
    
    
    
    
    
    
    
    

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