What�s the reason for the long delay?

Although there are many reasons for the delay, the primary explanation is that the Centers for Medicare & Medicaid Services does not have enough staff working on the ambulatory surgery center (ASC) issue to provide the work that is needed to keep a program up to date, according to Kathy Bryant, executive director of the Federated Ambulatory Surgery Association in Alexandria, VA.

�The nonpolitical appointee staff working on our issue are some of the finest government officials I have ever encountered,� Bryant says. �They are eager to follow the law and support the ASC benefit; however, they are constantly called to work on a whole range of other outpatient services; and quite frankly, ASCs always fall to the bottom of the barrel.�

Because ASCs are the smallest, this low priority makes sense from their perspective, she maintains. Other, less important factors in the delay were questions concerning exactly what the rule should say and whether payment and list changes were separate.