Bill > S1629

This bill aims to standardize Medicare fee-for-service payment rates across different ambulatory (outpatient) healthcare settings, starting in 2027. Specifically, the bill requires the Secretary of Health and Human Services to identify at least 66 ambulatory payment classifications that can be performed in various settings like hospital outpatient departments, ambulatory surgical centers, and other appropriate settings, and apply a "site neutral payment rate" to these services. This means that regardless of where a covered medical service is performed, Medicare will reimburse at a consistent rate. The bill includes an important exception for emergency department visits, critical care visits, and trauma care visits, which will be treated as Comprehensive APCs (Ambulatory Payment Classifications) with a packaged payment approach. The legislation was informed by recommendations from the Medicare Payment Advisory Commission (MedPAC) and is designed to potentially reduce healthcare costs by eliminating payment disparities based on the location of service. The bill makes conforming amendments to various sections of the Social Security Act to implement these changes, ensuring that the new payment methodology is consistently applied across different Medicare payment systems.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/1629/all-info