Bipartisan Legislation Reintroduced To Improve Access To Affordable Outpatient Surgery For Medicare Beneficiaries

U.S. Senators Bill Cassidy, M.D. (R-LA), Richard Blumenthal (D-CT), and U.S. Representatives Brad Wenstrup, D.P.M. (R-OH-02) and John Larson (D-CT-01) have reintroduced bipartisan, bicameral legislation that aims to improve access to affordable outpatient surgical care for Medicare beneficiaries. The Outpatient Surgery Quality and Access Act is designed to eliminate copay penalties, address reimbursement gaps, and remove other barriers that limit seniors’ access to Ambulatory Surgery Centers (ASCs).

According to projections, ASCs offer many vital outpatient services at low prices, and their increased use is projected to save Medicare billions of dollars in the coming years. However, current restrictions and misaligned reimbursement rules limit access to these centers and lead to higher costs for taxpayers.

“As a physician, I understand how important it is that patients receive the care they need. Ambulatory surgical centers play an important role in providing this care and this bill will improve access to these vital facilities,” said Dr. Wenstrup, D.P.M. 

The bill aims to close the reimbursement gap that results in Medicare paying hospital outpatient departments twice as much as ASCs for identical services. Moreover, the legislation would provide patients with cost and quality comparison measures to enable them to make informed decisions when choosing a surgical facility. Additionally, the legislation would increase transparency surrounding the Centers for Medicare & Medicaid Services’ (CMS) decision-making process for covering procedures performed by ASCs. By removing these barriers, the legislation seeks to expand seniors’ access to quality care while also reducing costs for taxpayers.

“Patients shouldn’t be charged more for a procedure just because it was performed by an outpatient provider. The current restrictions on Ambulatory Surgery Centers are an unnecessary burden – limiting seniors’ access to care and driving up health care costs,” said Senator Blumenthal. “Our bill will ensure patients have access to the quality care they deserve and save taxpayers money.”

The Outpatient Surgery Quality and Access Act has received support from various stakeholders, including ASCs and physician groups. Supporters argue that the legislation could have a significant impact on Medicare beneficiaries’ access to affordable care, particularly in areas where access to traditional hospitals is limited.

Under the bill, CMS would be required to develop and implement a plan to increase access to ASCs, including by providing comparative cost and quality data. Moreover, the legislation would provide much-needed relief for patients by eliminating copay penalties, which can be a significant financial burden for seniors with limited resources.

“I am proud to join my colleagues to introduce this legislation to expand access to outpatient surgical care, saving Connecticut residents and Americans across the country valuable dollars. This bill is another step in ensuring quality and accessible care, while ensuring seniors’ tax dollars are spent wisely,” said Representative Larson.

The Outpatient Surgery Quality and Access Act has the potential to significantly improve access to affordable, high-quality outpatient surgical care for Medicare beneficiaries. The legislation’s reintroduction is an encouraging development for seniors, ASCs, and the healthcare industry as a whole. Its success could have far-reaching implications for healthcare access and affordability in the United States.