Sponsors (2)
The bill increases and stabilizes payments to ASCs—improving access and predictability for beneficiaries and providers—but does so at the cost of higher Medicare spending and added pressure on federal budgets and provider payment balances.
Medicare beneficiaries will likely see improved access to and continuity of ambulatory surgical center (ASC) services because ASC payments will rise with OPD fee schedule increases starting in 2027, reducing the chance of sudden cuts that disrupt care.
ASCs, hospitals, and healthcare workers gain higher and more predictable Medicare payments, aiding financial planning for providers and helping sustain availability of outpatient surgical services.
HHS/CMS and providers will have clearer, more transparent accounting because actual ASC spending must be counted when calculating budget-neutrality adjustments, aligning CMS calculations with real expenditures.
Taxpayers and the Medicare trust fund face higher federal spending because ASC payment increases — combined with a prohibition on offsets — raise aggregate Medicare outlays and could strain program finances.
Medicare beneficiaries and outpatient providers could experience payment volatility during the transition if budget-neutrality offsets are disallowed, potentially disrupting provider revenue and patient access in some areas.
Hospitals and health systems may face budgetary imbalances or a shift of services toward ASCs as ASC payments rise relative to hospital payments, which could change local care mixes and strain certain providers.
Based on analysis of 3 sections of legislative text.
Aligns ASC annual Medicare payment updates with the OPD fee schedule increase factor starting in 2027 and changes how budget‑neutrality offsets are applied.
Official title: Amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program.
Introduced July 14, 2026 by Bill Cassidy · Last progress July 14, 2026
Requires Medicare to update ambulatory surgical center (ASC) payments each year beginning in 2027 using the same outpatient department (OPD) fee schedule increase factor used for hospital outpatient departments. It also bars an ASC‑specific budget neutrality adjustment after 2026 and requires CMS to include ASC spending when calculating budget‑neutrality adjustments for OPD updates starting in 2027. The change modifies how annual ASC payment updates are calculated and how budget‑neutrality offsets are applied, but does not create a new program or add a separate appropriation. It takes effect for calendar year 2027 and later years.