Episode 263 - Latest News, Delay in Pre-Auth Pilot, Anthem Policy, Final CMS ASC/HOPD 2026 Payment Rule - December 3, 2025
Description
In this episode of the ASC Podcast with John Goehle we discuss the latest news, including the delay in the Pre-authorization pilot and Anthem’s new policy on out-of-network providers. In our focus segment we discuss the final 2026 CMS ASC/HOPD Payment Rule
This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies.
Notes and Resources from this Episode:
- Final Rule:
- Press Release about Final Rule:
- Fact Sheet about Final Rule:
- Downloads for the Final Rule:
- ASC Quality Reporting web site:
- ASC Association Web Site (Join to get more information):
INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE
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Important Resources for ASCs:
- Conditions for Coverage:
- Infection Control Survey Tool (Used by Surveyors for Infection Control)
- Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM)
- https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf
- https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som
- Policy & Memos to States and Regions
- CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
- https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions
Other Resources from the ASC Podcast with John Goehle:
Visit the ASC Podcast with John Goehle Website
Books by John Goehle
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