Complete Story
01/14/2011
Division of Workers' Compensation Proposing 20% Reduction in ASC Reimbursement
CASA Asking All Members to Become Involved
Late Friday, December 17, 2010, the California Division of Workers’ Compensation (DWC) posted the proposed regulations regarding revisions to the ambulatory surgery center (ASC) and hospital outpatient departments (HOPD) fee schedule regulations for outpatient services provided in these facilities. The DWC is proposing to keep HOPDs at the current fee schedule and reduce ASC reimbursement to 100% of the CMS HOPD fee schedule. We need all ASCs to become active and let their voice be heard.
The CASA Board takes exception to the DWC removing ASC’s from parity with the HOPD. The services provided to the injured worker are the same regardless of the site of service and the reimbursement should reflect this. Disrupting the equilibrium between HOPD’s and ASC’s will cause surgery centers to opt out of treating workers' compensation clients due to cost concerns and creates potential gamesmanship incentives to move patients to a more “lucrative” setting. Creating a two tier system will cause access issues for the injured worker and we believe the DWC is seriously miscalculating the overall cost reductions they are trying to achieve. It is imperative that the DWC and Governor Jerry Brown hear and understand this argument. CASA met with Brown in August to discuss this issue at length and hope to resume those talks very soon.
We need all California ASCs to become involved. Please plan to participate in as many of the following activities as possible.
- DWC Hearing January 25, 2011
A hearing on the proposed regulations is scheduled for Tuesday, January 25th in Oakland. We strongly encourage you and your physicians to attend this hearing. See the following announcement link for time and address of hearing. DWC hearing announcement - Submit written comments to the DWC
CASA has formally submitted comments to the DWC. We encourage all of our members to offer their own comments along with their physicians. In the following link is a sample letter that you can personalize and edit to meet your needs. sample WC letter You may send comments on the proposed regulations to dwcrules@hq.dir.ca.gov. Unless submitted prior to or at the public hearings, all written comments must be received by the agency contact person no later than 5:00 p.m. on January 25, 2011. Links to CASA’s submitted written comments, as well as the notes to prior hearings, are listed below.
History has proven that it will take a strong and unified voice to effectively communicate our arguments and concerns. Please join us in actively communicating our message. If you have questions or are in need of guidance, CASA Executive Director, Beth LaBouyer, is available to assist you. She can be reached at 530-790-7990 or info@casurgery.org.
