Outpatient Surgery Access Act of 2026
Sponsored By: Representative Van Duyne
Introduced
Summary
This bill would tie ambulatory surgical center (ASC) payment updates to the hospital outpatient department (OPD) fee schedule update and recalibrate budget-neutrality rules. It focuses on making ASC annual updates follow the OPD increase factor and on changing how budget neutrality is applied starting in 2027.
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- Ambulatory surgical centers (ASCs): Would set the ASC annual payment update equal to the OPD fee schedule increase factor for 2027 and each year after, with the specified statutory adjustments. This changes the formula that determines year-to-year ASC payment increases.
- Medicare payment calculations and CMS duties: Would bar ASC-specific budget neutrality adjustments beginning in 2027 and require the Secretary to include expenditures under the revised ASC payment system when determining adjustments under section 1833(t)(9)(B). This changes how CMS must factor ASC spending into overall adjustment calculations.
- Aggregate ASC expenditures: Together the changes make ASC payments and aggregate ASC expenditures reflect the revised payment system rather than being forced to match spending levels that would have occurred without these amendments.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Medicare outpatient surgery payment changes
This bill would change how Medicare pays for outpatient surgeries at ambulatory surgical centers starting in 2027. Each year the ASC payment update would equal the outpatient department (OPD) fee-schedule increase factor for that year, with the statute's listed adjustments. The bill would also bar ASC-specific budget-neutrality offsets and require the Secretary to count spending under the new ASC payment system when making other payment adjustments. If enacted, this could change what centers are paid and could affect beneficiary cost-sharing or Medicare program spending.
Sponsors & CoSponsors
Sponsor
Van Duyne
TX • R
Cosponsors
Rep. Larson, John B. [D-CT-1]
CT • D
Sponsored 3/25/2026
Roll Call Votes
No roll call votes available for this bill.
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