Medicare's Oversight of Ambulatory Surgery Centers

Because ambulatory surgery centers (ASCs) often perform complex medical procedures, including invasive surgeries under general anesthesia, we examined how Medicare ensures that ASCs meet minimum health and safety requirements through its State survey process. Most ASCs (known as nondeemed ASCs) undergo a State agency survey to demonstrate that they meet these requirements; the others (known as deemed ASCs) are accredited by a Medicare-approved accreditor. In addition to conducting regular surveys of nondeemed ASCs, States also conduct investigations of complaints that allege poor care or other problems at both types of ASCs. Medicare beneficiaries are increasingly using ASCs for outpatient surgical procedures. In fact, Medicare payments to ASCs increased from $3.4 billion in 2011 to $4.6 billion in 2017.