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Episode 251 - Proposed CMS 2026 Payment Rule, News and Latest Trends in the ASC Industry - July 21, 2025
ASC Podcast with John Goehle
46 minutes 18 seconds
3 months ago
Episode 251 - Proposed CMS 2026 Payment Rule, News and Latest Trends in the ASC Industry - July 21, 2025
In this episode of the ASC Podcast with John Goehle, we discuss the latest news and trends in the ASC industry and review the proposed 2026 CMS Payment Rule for ASCs and HOPDs.
This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies.
Notes and Resources from this Episode:
Ambulatory Surgery Center News - 9 Quotes that capture 2025 for ASC’s:
https://ascnews.com/2025/06/you-dont-have-to-play-by-hospital-rules-what-asc-leaders-are-saying-right-now/?spMailingID=161608&puid=4098726&E=4098726&utm_source=newsletter&utm_medium=email&utm_campaign=161608
Healthcare Dive Article June 23 - How health insurers are pledging to reform prior authorization:
https://www.healthcaredive.com/news/health-insurers-pledge-prior-authorization-reform-trump-hhs/751309/
2026 Proposed CMS ASC/HOPD Payment Rule:
https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices/cms-1834-p
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Important Resources for ASCs:
Conditions for Coverage:
https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150
Infection Control Survey Tool (Used by Surveyors for Infection Control)
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf
Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM)
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf
https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som
Policy & Memos to States and Regions
CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions
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