Commission Moves to Limit Retroactive Reimbursements for Ambulatory Surgery Centers

The North Carolina Industrial Commission has proposed a permanent rule that would limit employer and carrier exposure to retrospective payments of $10 million or more while it waits for the Court of Appeals to rule on a challenge to its new fee schedule for ambulatory surgery centers. Surgical Care Affiliates, which operates 200 ASCs nationwide and seven in North Carolina, sued the commission to invalidate a Medicare-based fee schedule enacted April 1, 2015. The previous fee schedule was based on a percentage of billed charges.  A Wake County judge 11 months ago ruled that the...