This bill would change part of the Social Security Act (section 1833) to limit some coinsurance charges for services given in ambulatory surgical centers (ASCs). If the normal coinsurance for ASC facility services for a surgical procedure in a year would be more than the inpatient hospital deductible for that year, the bill requires the coinsurance to be reduced to equal the inpatient hospital deductible. The Secretary of Health and Human Services would pay the ASC an amount equal to that reduction. The change would apply to services furnished on or after January 1, 2026. The bill was introduced in the Senate on May 15, 2025, by Senators Bill Cassidy and Richard Blumenthal and was referred to the Senate Committee on Finance.
If you are a Medicare beneficiary who gets a surgical procedure in an ambulatory surgical center, this bill would cap the facility coinsurance you owe for that procedure at the annual inpatient hospital deductible amount for that year. The Medicare program would pay the ASC the difference between the original coinsurance and the capped amount. This cap would start for services on or after January 1, 2026.
The bill directs the Secretary to pay ASCs an amount equal to any reduction in the coinsurance, but it does not include estimates of total federal spending or dollar costs. No publicly available information on overall cost estimates is included in the bill text or provided metadata.
No publicly available information.
No publicly available information.