Issue link: https://beckershealthcare.uberflip.com/i/1252329
16 ASC MANAGEMENT UnitedHealthcare, Optum accelerating $2B in provider payments & support — 6 details By Angie Stewart U nitedHealth Group is accelerating nearly $2 billion in payments and financial support to U.S. healthcare providers through its UnitedHealthcare and Optum subsidiaries, according to an April 7 announcement. What you should know: 1. The accelerated claim payments for medical and behavioral care provid- ers apply to UnitedHealthcare's fully insured commercial, Medicare Advan- tage and Medicaid businesses. 2. UnitedHealth Group's financial support includes $125 million in small business loans for Optum Health's partnered clinical operators. 3. UnitedHealth Group has also suspended prior authorization require- ments for post-acute care settings and for when members change provid- ers. 4. For Medicare Advantage, Medicaid, and individual and group market health plans, the payer extended timely filing deadlines for claims during the COVID-19 public health emergency period. 5. In addition, UnitedHealth Group implemented provisional credentialing to remove barriers to network participation for out-of-network independent practitioners. 6. In a prepared statement, HCA Healthcare CEO Sam Hazen applauded UnitedHealthcare's actions. Mr. Hazen said the relaxed rules will mitigate hardship for providers handling the costs of COVID-19 relief efforts. n New Hampshire ASC loses 80% of business to COVID-19, closes 1 location By Eric Oliver B edford (N.H.) Ambulatory Surgical Center CEO Nick Vailas said his surgery center has lost about 80 percent of its business due to the COVID-19 pandemic, the New Hampshire Union Leader reports. The ASC is still performing urgent procedures because "we don't want those people also having to go to the hospital," Mr. Vailas said. Because of the lost revenue, the ASC laid off an unspecified number of employees, cut pay to other employees and closed one of its offices. Despite the current concerns and the uncertainty related to the coronavirus, Mr. Vailas urged others to stay positive: "You try to mitigate as much of the damage as possible and stay optimistic." n The rise of cardiology in ASCs — 5 insights By Eric Oliver C ardiovascular procedures are emerg- ing in the outpatient setting aer a push from CMS. Here are five insights from e National Law Review on how cardiovascular proce- dures migrated to the outpatient setting: 1. Cardiovascular services are less expen- sive in the outpatient setting and provide "greater comfort and convenience" for patients. 2. CMS encouraged the migration by add- ing 17 cardiac catheterization procedures to the ASC-payables list in 2018, and then authorized the provision of percutaneous coronary interventions by adding six CPT codes to the payables list in 2019. 3. ASCs are adding cardiovascular pro- grams through either co-management arrangements or by implementing hybrid models. In co-management models, ASCs contract with a cardiovascular medical group to run a cardiovascular program within the ASC. In the hybrid model, the ASC builds a freestanding office-based laboratory, catheterization laboratory or vascular access center within the ASC. 4. Despite having approval from CMS, ASCs must work within state restrictions around developing cardiovascular pro- grams. About 33 percent of states do not permit the hybrid model, and some states do not allow ASCs to perform all the CMS- approved procedures. 5. Most states, too, have a certificate-of- need requirement around establishing new service lines. Despite the hurdles, e National Law Review said, "We imagine the trend towards the provision of outpatient surgical services in the ASC setting to continue as CMS continues to increase the number of ASC cardiovascular procedures reimbursable under Medicare and states weaken their unfavorable restrictions." n