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News: Legislative Updates

Ambulatory surgical centers split over ending assessment

Monday, February 27, 2017   (0 Comments)
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February 22, Wisconsin Health News


Gov. Scott Walker's budget proposes the elimination of a tax on ambulatory surgical centers and supplemental funding, which some centers warn could increase Medicaid costs while others say could enhance their ability to provide care.


The state imposes an assessment on the centers that participate in Medicare based on gross patient revenue. The tax allows the state to collect additional federal matching funds for Medicaid.


In his budget, Walker recommends eliminating the assessment and supplemental payments to ambulatory surgical centers. Walker's budget would provide an additional $5.2 million in general purpose revenue over the next two years. Elizabeth Goodsitt, DHS spokeswoman, said the funding represents the net gain the department would have realized if it continued the assessment. But the state would lose about $17.3 million in federal and other sources of funding over the two year-period.


Vishal Lal, CEO of Advanced Pain Management, said they're disappointed in Walker's decision. Advanced Pain Management has 19 ambulatory surgical centers throughout the state that would be impacted. Nearly a quarter of their patients are in Medicaid. "If the ASC Assessment is repealed, it will be very challenging for APM to continue serving the high level of Medicaid patients that it currently serves," he said in a statement. "This may require patients to find treatment at a hospital, which is reimbursed at a higher rate for the same services, increasing the state's overall Medicaid costs." The assessment has allowed Wisconsin to supplement reimbursement and maintain patient access to health services, he said. If the assessment is eliminated, they hope for alternative solutions "to ensure adequate reimbursement," he said.


Still Curt Kubiak, CEO of the Orthopedic & Sports Institute of the Fox Valley, praised the governor's decision. He said they've been petitioning state lawmakers for years to have the tax removed. They between $400,000 and $500,000 a year and receive about $75,000 to $100,000 back, he said. "It's really counterproductive for us to take on these higher cases and perform these more complex surgeries and be penalized by the state," he said. If the assessment is repealed, they hope to hire new staff and purchase more equipment to take on more complex surgery cases, he said.


John Gardner, Marshfield Clinic Health System spokesman, said they're still assessing what impact the proposal could have on their four ambulatory surgical centers, which are located in Marshfield, Wausau, Minocqua and Eau Claire. "In the past the assessment has been an important tool in helping to cover the costs associated with the significant number of Medicaid patients we see," he said in a statement.


Stephanie Harvey, CEO of Independence Surgery Center in Chippewa Falls, said her ophthalmology surgical center has lost money through the assessment sometimes and received more money back from the state other times. "We've been winners some years, we've been losers," Harvey said. "Personally, we could go either way with this." Harvey, who is president of the Association of Wisconsin Surgery Centers, said the organization hasn't taken an official position because they have centers who fall on both sides of the issue. She hopes that the ambulatory surgical centers that could be negatively affected through a repeal are secure enough financially that it won't matter what payer covers services.

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