Sponsors (2)
The bill locks in annual ASC payment updates and accounting rules that improve access and revenue predictability for ASCs and their patients, but it likely raises Medicare spending and shifts payment burdens in ways that could increase costs for taxpayers and beneficiaries and create winners and losers among providers.
Medicare beneficiaries (especially seniors) may get more stable or increased access to outpatient procedures at ambulatory surgical centers (ASCs) because ASC payments will be updated annually (tied to OPD updates) and CMS is restricted from reducing ASC aggregate spending beginning in 2027.
Ambulatory surgical centers, hospitals, and healthcare workers gain more predictable and potentially higher Medicare payments for ASC services starting in 2027, improving budgeting and financial stability for providers.
Requiring CMS to account for ASC expenditures when calculating OPPS adjustments increases transparency and alignment across outpatient payment systems, making payment rules more consistent.
Taxpayers and Medicare trust funds could face higher federal spending if ASC payments rise with OPD updates and budget-neutral offsets are limited, increasing program costs and fiscal pressure.
Medicare beneficiaries and retirees could face higher premiums, increased cost‑sharing, or greater pressure on Medicare Part A/B finances over time if ASC payment increases are not offset elsewhere.
Hospitals and other OPPS-paid providers could lose revenue (while ASCs gain) if OPPS adjustments are recalculated to account for ASC expenditures, creating winners and losers across sites of service and potentially affecting access in some settings.
Based on analysis of 3 sections of legislative text.
Aligns ASC annual updates with the OPD fee schedule increase factor starting in 2027, bars ASC-specific neutrality offsets, and folds ASC spending into OPPS neutrality calculations.
Changes how Medicare pays ambulatory surgical centers (ASCs) by tying the ASC annual payment update to the outpatient department (OPD) fee schedule increase factor beginning in 2027, prohibiting ASC-specific budget-neutrality offsets, and requiring that ASC expenditures be included when computing OPPS budget-neutrality adjustments. The result is a new, predictable annual update rule for ASC payments and a shift in how Medicare neutralizes payment changes across outpatient settings, with potential effects on ASC revenue, hospital outpatient payments, Medicare spending, and beneficiary cost-sharing.
Introduced March 25, 2026 by Beth Van Duyne · Last progress March 25, 2026