ASC Standing Compliance Reference

This page lists ongoing ASC Medicare certification and accreditation items that remain in effect. It is updated only when an item changes. Last reviewed: July 17, 2026.

Standing Regulatory Items

  • CY 2026 OPPS/ASC Final Rule (CMS-1834-FC) — In effect since Jan 1, 2026. 2.6% ASC payment update for ASCQR-compliant centers; 547 procedures added to the ASC Covered Procedures List. Failure to meet ASCQR reporting = 2% payment reduction. CMS Fact Sheet
  • CY 2027 OPPS/ASC Proposed Rule (CMS-1850-P) — Published in the Federal Register July 7, 2026. Proposes a 2.4% ASC payment update, Year 2 of the inpatient-only (IPO) list phase-out (638 services), ASCQR measure changes, expanded prior authorization for botulinum toxin codes, and AO deeming for EMTALA administrative requirements. Comment deadline: August 31, 2026. Federal Register
  • Conditions for Coverage (42 CFR Part 416) — Ongoing ASC health and safety standards: governing body, surgical services, patient rights, infection control, admission/assessment/discharge. eCFR Part 416
  • ASCQR Program participation — Required annually to receive the full payment update.
  • ASC prior authorization demonstration (10 states) — Five-year CMS demonstration covering Arizona, California, Florida, Georgia, Maryland, New York, Ohio, Pennsylvania, Tennessee, and Texas. Originally set to begin Dec 15, 2025; delayed and phased. Phase 1 (CA, FL, GA, MD, NY, PA, TN): dates of service on/after January 19, 2026. Phase 2 (AZ, OH, TX): dates of service on/after February 16, 2026. 41 codes across blepharoplasty/blepharoptosis/brow ptosis repair, botulinum toxin injection, panniculectomy and excess-skin excision, rhinoplasty, and vein ablation. ASCA
  • HHS Section 504 accessible medical equipment (MDE) rule — Effective July 8, 2026, ASCs receiving federal financial assistance (Medicare/Medicaid) must have at least one accessible exam table and one accessible weight scale (or 10% of each MDE type, whichever is greater), plus an ongoing new-acquisition obligation for MDE acquired after July 8, 2024. Related digital-accessibility (WCAG 2.1 AA) deadlines were extended to May 11, 2027 (15+ employees) and May 10, 2028 (fewer than 15). Enforced by HHS OCR. HHS MDE Requirements
  • CRNA physician-supervision state opt-outs (42 CFR 416.42(c)). A state may exempt its ASCs from the Medicare physician-supervision requirement for CRNAs at 42 CFR 416.42(b)(2) when the governor submits an attestation letter to CMS; the exemption is effective upon submission, with no CMS approval step. 27 states have opted out, most recently Ohio (letter submitted July 10, 2026), which followed Ohio HB 52 (effective June 8, 2026) replacing “supervision” with “collaboration” under state law. The opt-out lowers the federal floor only — state scope-of-practice law, medical staff bylaws, governing-body policy, credentialing/privileging, and payer contracts may still require supervision independently, and surveyors hold the ASC to its own adopted policy. Source: AANA — Ohio Opts Out of Physician Supervision for CRNAs

Standing Accreditation Items

  • Accrediting organizations (deemed status) — There are five CMS-approved national ASC accreditors: AAAHC, ACHC (Accreditation Commission for Health Care, formerly HFAP), DNV Healthcare (initial ASC approval effective Dec 8, 2025 – Dec 10, 2029), The Joint Commission, and QUAD A (formerly AAAASF). ASCA — Accrediting Organizations
  • AAAHC v44 Standards — 2026 is the first full survey year. Expanded focus on data collection/outcomes, alignment with state scope-of-practice rules, integration with Quality Roadmap reports. OR Today
  • AAAHC v45 Standards and AI governance — Covered in AAAHC’s 2026 Achieving Accreditation education programs. ASC Focus
  • Joint Commission 2026 standards — Environment of Care and Life Safety consolidated into a single Physical Environment chapter; greater focus on performance outcomes and equipment condition during tracers. OR Today

Standing Oversight Items

  • CMS AO oversight final rule (42 CFR Part 488) — Strengthening Oversight of Accrediting Organizations and Preventing AO Conflicts of Interest, finalized June 12, 2026. Signals more rigorous, standardized, and independent accreditation surveys. Summary
  • HHS-OIG 2026 Work Plan — Heightened healthcare enforcement environment in 2026. No ASC-specific audit currently flagged; keep billing, medical-necessity, and certification documentation audit-ready. Saul Ewing