01/28/2020

ASCA Submits Formal Comments to Department of Defense

ASCA submitted formal comments in response to a proposed rule from the Department of Defense that would align TRICARE ASC payments with Medicare’s payment methodology. ASCA suggests a few modifications to the proposed rule, such as asking TRICARE to adopt CMS’ separate payment for non-opioid pain management drugs policy as well as updating ASC payments using the hospital market basket. ASCA also notes that some unlisted codes previously payable under TRICARE are not currently payable under Medicare, and therefore the alignment may cause loss of access to certain procedures. Finally, ASCA asks for additional clarification around beneficiary copayments and asks TRICARE to explore changes that would alleviate issues regarding delayed reimbursement.