Joe Peluso, administrator at Aestique Surgery Center in Greensburg, Pa., joined Becker’s to discuss how proposed federal legislation — including H.R. 879 and S. 1640 — and CMS’ 2026 payment system reforms could stabilize physician reimbursements, advance site-neutral payments, and strengthen patient access to cost-effective outpatient care.
Joe Peluso: Here are some thoughts regarding the challenges ASCs owners and independent physicians face that are not understood by policy makers or the general public including declining Medicare reimbursements, the impact of current copay policies and stabilizing Medicare payments for independent physician practices that support referrals to ASCs.
H.R. 879 bill proposes a permanent update to stabilize the physician Medicare fee schedule and companion bill S.1640 would increase physician Medicare reimbursement by 8.51% that would reflect a prorated reversal of the negative 2.83% Medicare cut to physicians since January 2025. These proposed legislative initiatives would provide payment stabilization for independent physicians and protect patient’s access to quality healthcare.
CMS has proposed the 2026 OPPS and ASC payment system reforms that provide for site neutrality by equalizing payments and phasing out the inpatient only list for ASCs and hospitals. This legislation would deliver millions of dollar savings to Medicare and beneficiaries and enable physicians to determine the appropriate setting for care, allow patients to choose outpatient surgical options, and provide patients better and timely access to care.
These legislative proposed changes highlight a unique opportunity to enable ASC owners and independent physicians to continue to deliver high quality, safe and cost-effective care to numerous members of our communities. ASCs perform approximately 72% of all outpatient surgeries across the nation every year at 45% to 60% lower costs. The savings derived from these initiatives would positively impact payer costs (Medicare, insurers), and patients out of pocket expenses.
