ASC Daily Briefing — August 21, 2026

By consulting | August 21, 2026 |

New Today

Surgical smoke evacuation is now mandated in 22 states — Maryland, Michigan, and Delaware are the newest. Michigan HB 4779 (signed July 21, 2026) is effective immediately and requires health facilities including ASCs to use a smoke plume evacuation system during any surgical procedure involving heat-producing equipment likely to generate smoke. Delaware HB 173 took effect April 1, 2026. Maryland HB 1087 (signed May 26, 2026) takes effect January 1, 2028 and requires a written policy mandating evacuation systems. Michigan ASCs are out of compliance today if they have no policy and no evacuation equipment in use — this is a written-policy-plus-equipment requirement, and surveyors will look for both.
Source: ASC Focus — More states enforce surgical smoke evacuation requirements for ASCs (Aug 10, 2026)

CMS published ASC-specific billing guidance for Encelto (revakinagene taroretcel-lwey) in the August 20 MLN Connects. Medicare pays for the cell gene therapy drug in ASCs for claims with dates of service on or after October 1, 2025 — meaning this is retroactively billable. ASCs bill it like CAR T-cell therapy under HCPCS J3403, submitting multiple fractionated claims with the LU modifier (fractionated billing) and 76 modifier (repeat service), per Medicare Claims Processing Manual Ch. 32 §400.2.5. Only 1 total unit of J3403 per date of service per eye treatment. At roughly $261,580 per implant, a fractionation error here is a large-dollar denial.
Source: CMS — MLN Connects Newsletter for August 20, 2026

ASCA released its HIPAA biannual update for January–June 2026 — PHI breaches hit a post-2020 low. Healthcare organizations posted 248 breaches affecting 500+ individuals in the first half of 2026, the lowest six-month total since the second half of 2020 and a 31% decrease from the first half of 2024. Unauthorized access and hacking now account for 99% of breaches, and for the first time since ASCA began the series, neither loss nor improper disposal of PHI was cited as a cause. Practical read: physical-safeguard controls are working; the remaining exposure is essentially all cyber. OCR’s Right of Access Initiative remains the most active enforcement channel — verify your 30-day records-request turnaround is documented.
Source: ASC Focus — HIPAA Biannual Update, January to June 2026 (Aug 20, 2026)

Flag — CCSQ Quarterly Stakeholder Webinar, Wednesday August 26, 11 am–12 pm ET. CMS Chief Medical Officer Dr. Dora Hughes and the Center for Clinical Standards and Quality leadership team will give a policy update. CCSQ owns survey and certification, the Conditions for Coverage, and the quality reporting programs — this is the CMS group whose decisions land directly on ASC certification. Registration is open through the MLN Connects listing.
Source: CMS — MLN Connects Newsletter for August 20, 2026

Standing Items Changed

  • New standing regulatory item added — state surgical smoke evacuation requirements (22 states; MD, MI, DE newest; Michigan effective immediately, Maryland effective January 1, 2028). Added to the Standing Compliance Reference.
  • No existing standing item was superseded or expired today. “Last reviewed” advanced to August 21, 2026.
  • Verification: the August 20 standing-Page edit did persist this time — the Page’s modified timestamp read August 20, 2026 at the start of today’s run, confirming the v45/v44 and Oregon changes are live. The August 19 failure has not recurred.

Already Captured (no action)

Everything else surfaced today is already on the Standing Compliance Reference or in recent briefings: the CY 2027 OPPS/ASC Proposed Rule (CMS-1850-P, Federal Register July 7, comment deadline August 31, 2026), the CY 2026 OPPS/ASC Final Rule (CMS-1834-FC) in effect, the Conditions for Coverage at 42 CFR Part 416, the HHS Section 504 accessible MDE baseline and extended digital-accessibility deadlines, the 10-state ASC prior-authorization demonstration, the state CRNA physician-supervision opt-outs, AAAHC v44 (surveys through December 14, 2026) and v45 (surveys on or after December 15, 2026), the 1095 Advance AI Governance Guide, the AAAHC service-line statement, the Oregon OHA deemed-status relicensure agreement, The Joint Commission 2026 standards, the five CMS-approved ASC accreditors, the CMS AO-oversight final rule, the HHS-OIG 2026 Work Plan, the RAPID device coverage pathway (comments due October 13, 2026), and the Washington state wildfire PHE 1135 waivers.

The HHS 2026 Unified Agenda published August 14 lists CMS-1850 (CY 2027 OPPS/ASC) as its only ASC-relevant entry, flagged for Section 610 review — no new ASC rulemaking on the agenda. The only CMS Federal Register documents published today are two generic Paperwork Reduction Act collection notices and a Privacy Act system-of-records notice, none of which reference ASCs. No new CMS enforcement actions, deemed-status terminations, or accreditor announcements. QUAD A has posted nothing since July 31; AAAHC’s only post today is a conference appearance.

Reminder: the CY 2027 Proposed Rule comment deadline (August 31, 2026) is 10 days out. ASCA has published customizable comment letter templates for members if you intend to file.

Sources

Posted in ASC Daily Briefing

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