SOS: Sustaining Outpatient Services Act
Sponsored By: Representative Smith (NE)
Introduced
Summary
This bill would move payment for certain off-campus outpatient services to the hospital outpatient prospective payment system. It applies starting in 2027 to items or services furnished by an off-campus outpatient department when the physician specialty’s total physician-fee-schedule payments in the prior year were less than $2 million.
Show full summary
- Off-campus outpatient departments: Services that meet this rule would be paid under the hospital outpatient prospective payment system beginning in 2027.
- Smaller physician specialties: If a specialty's total prior-year payments under the physician fee schedule were under $2 million, items they furnish at off-campus outpatient departments would be shifted from physician-fee-schedule payments to hospital outpatient prospective payment determinations.
- Medicare payment rules: For the covered items and services, Medicare would replace prior physician-fee-schedule-based payments with hospital outpatient prospective payment system rates when the prior-year specialty threshold is met.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Medicare payment shift for off-campus care
If enacted, beginning in 2027 Medicare would pay some services given at off-campus outpatient departments under the hospital outpatient prospective payment system instead of the physician fee schedule. The rule would apply when the physician specialty had less than $2,000,000 in physician-fee-schedule payments for those same services in the prior year. The change would move payment from doctor-fee rules to hospital outpatient rates. That shift could change what Medicare beneficiaries pay out of pocket for the affected services.
Sponsors & CoSponsors
Sponsor
Smith (NE)
NE • R
Cosponsors
McGovern
MA • D
Sponsored 2/24/2026
Roll Call Votes
No roll call votes available for this bill.
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