Modernizing Medicare Payments and Quality Transparency for Outpatient Surgery Centers.
This Act aims to modernize Medicare payments for Ambulatory Surgical Centers (ASCs), potentially increasing the availability and quality of outpatient surgical services. It mandates greater transparency by requiring side-by-side comparisons of quality data between ASCs and hospital outpatient departments for citizens. Crucially, it caps the patient's copayment for ASC services at the inpatient hospital deductible amount, which could significantly reduce out-of-pocket costs for Medicare beneficiaries.
Key points
Cost Cap for Patients: The maximum copayment for a procedure at an Ambulatory Surgical Center (ASC) cannot exceed the annual Medicare inpatient hospital deductible, protecting patients from excessive fees.
Quality Comparison: Quality data for surgical services at ASCs and hospital outpatient departments must be made publicly available on Medicare.gov, allowing citizens to compare facilities in the same geographic area.
Payment Alignment: Annual payment updates for ASC services will be aligned with the updates provided for hospital outpatient department services starting in 2024.
Transparency in Procedure Exclusion: The government must cite specific, evidence-based criteria when excluding a procedure from the list of approved ASC services, enhancing regulatory clarity.
Expired
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