summary
Introduced
09/17/2019
09/17/2019
In Committee
09/18/2019
09/18/2019
Crossed Over
Passed
Dead
12/31/2020
12/31/2020
Introduced Session
116th Congress
Bill Summary
To amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program, and for other purposes. This bill establishes and modifies certain requirements relating to Medicare payments for ambulatory surgical center (ASC) services. Specifically, the bill (1) requires the payment system for ASC services to feature certain positive annual adjustments equivalent to those made with respect to hospital outpatient department (OPD) services; (2) revises quality reporting requirements to permit publicly available, side-by-side comparisons of quality measures for ASCs and OPDs in the same geographic area; and (3) requires the Centers for Medicare & Medicaid Services (CMS), when excluding requested procedures from the list of those approved to be performed in ASCs, to cite specified reasons for doing so. With respect to excluding procedures from the approved list for ASCs, the CMS may not cite as a basis for exclusion that a procedure can only be reported using an unlisted surgical procedure code. (Physicians sometimes use unlisted codes when performing new procedures or services if no existing code is adequately descriptive.)
AI Summary
This bill establishes and modifies certain requirements relating to Medicare payments for ambulatory surgical center (ASC) services. Specifically, it (1) requires the payment system for ASC services to feature annual adjustments equivalent to those made for hospital outpatient department (OPD) services, (2) revises quality reporting requirements to allow for public, side-by-side comparisons of quality measures for ASCs and OPDs in the same geographic area, and (3) requires the Centers for Medicare & Medicaid Services (CMS) to cite specific reasons when excluding requested procedures from the list of those approved to be performed in ASCs, prohibiting exclusion solely on the basis of the procedure being reported using an unlisted surgical code.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (20)
John Larson (D)*,
Gus Bilirakis (R),
Sanford Bishop (D),
Suzanne Bonamici (D),
Vern Buchanan (R),
Tom Cole (R),
Doug Lamborn (R),
Kenny Marchant (R),
Cathy McMorris Rodgers (R),
Devin Nunes (R),
Steven Palazzo (R),
Bill Posey (R),
David Roe (R),
David Schweikert (R),
Lloyd Smucker (R),
Greg Steube (R),
Steve Stivers (R),
Scott Tipton (R),
Jackie Walorski (R),
Bruce Westerman (R),
Last Action
Referred to the Subcommittee on Health. (on 09/18/2019)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.congress.gov/bill/116th-congress/house-bill/4350/all-info |
| BillText | https://www.congress.gov/116/bills/hr4350/BILLS-116hr4350ih.pdf |
| Bill | https://www.congress.gov/116/bills/hr4350/BILLS-116hr4350ih.pdf.pdf |
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