New legislation aims to improve ASC reimbursement, access to CMS

Bipartisan legislation aimed to improve CMS access to ASCs, dubbed The Outpatient Surgery Quality and Access Act of 2021, was recently introduced in the House and Senate, the Ambulatory Surgery Center Association said in a Nov. 3. email. 

Reps. John Larson, D-Conn., and Devin Nunes, R-Calif., and Sens. Richard Blumenthal, D-Conn., and Bill Cassidy, MD, R-La., introduced the legislation. 

The legislation would:

  • Require CMS to publish quality data that allows patients to compare sites of service.
  • Eliminate the copay penalty Medicare beneficiaries pay for certain services when they are provided in an ASC. 
  • Provide transparency with the criteria CMS is using to exclude procedures from the ASC-covered procedures list. 
  • Add an ASC representative to CMS' advisory panel on hospital outpatient payment, which makes decisions that affect both hospital outpatient department and ASC fees and procedures. 
  • Align the inflation update for ASCs and HOPDs.

"We want to thank the sponsors of the Outpatient Surgery Quality and Access Act for their efforts to reduce Medicare beneficiaries’ out-of-pocket costs and put the program on more stable footing," said ASCA CEO William Prentice. "Increasing access to care in ASCs can play an important role in reducing Medicare expenses, freeing up dollars for other priorities."

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