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US HR4350

US HR4350
Ambulatory Surgical Center Quality and Access Act of 2019


summary

Introduced
09/17/2019
In Committee
09/18/2019
Crossed Over
Passed
Dead
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)

Last Action

Referred to the Subcommittee on Health. (on 09/18/2019)

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