In the last year, there have been numerous policy shifts at both the federal and state levels affecting the daily operations and future growth of ASCs.
Rachel Rose, a healthcare attorney in Houston, recently joined Becker’s to discuss the most high-impact legislative and regulatory issues for ASCs.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What federal policy changes will have the most impact on ASCs over the next five years?
Rachel Rose: One of the biggest federal policy changes facing ASCs is the new reporting measures. Beginning in calendar year 2025, ASCs are required to report on 14 ASC quality reporting program measures to avoid Medicare penalties. This particular addition introduced untested measures requiring ASCs to collect social determinants of health data. Given the lack of instruction on how to effectively utilize the information, as well as other related changes that could be implemented over the next five years, this item could prove challenging from both an implementation/monitoring standpoint and a revenue cycle standpoint because of the potential penalties.
Q: What state policy changes will have the most impact on ASCs over the next five years?
RR: One of the biggest state policy changes facing ASCs is private equity ownership and the corporate practice of medicine. Texas, which is where I am based, along with California, Massachusetts and Illinois have all introduced legislation curtailing or eliminating private equity ownership in healthcare entities, including ASCs. On June 9, 2025, Oregon’s governor signed into law, legislation prohibiting management services organizations from having overlapping ownership or control with contracted medical practices. The dual-engagement restrictions, which constitute unlawful trade practices, take effect Jan. 1, 2026, for new market participants, while existing entities have a January 2029 compliance date. This is a trend that we will likely see arise in other states, too, over the next five years.
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