U.S. Reps. Mike Kelly, R-Pa., Robert Menendez Jr., D-N.J., Troy Balderson, R-Ohio, and John Larson, D-Conn., have introduced a bill that would cap co-pays at ASCs.
The Medicare Beneficiary Co-Pay Fairness Act of 2025 would benefit Medicare patients utilizing the over 6,300 Medicare-certified ASCs nationwide by saving them from high out-of-pocket expenses, according to an April 28 news release from Mr. Kelly.
Currently, only HOPDs, not ASCs, benefit from a co-pay cap, set at $1,676 for 2025. Read the full text of the bill here.
“I am proud to introduce this bill with my colleagues on both sides of the aisle to make surgical care more affordable and accessible for our seniors,” Mr. Larson said in the release. “Connecticut’s 61 ambulatory surgical centers provide preventive services and essential procedures to thousands of patients annually, including cataract surgeries and orthopedic care. The Medicare Beneficiary Co-Pay Fairness Act will ensure patients no longer have to pay more for a procedure simply because they went to an outpatient provider.”
