Outpatient Surgery Quality and Access Act of 2023
If enacted, HB972 will impact the Medicare reimbursement framework by adjusting annual payment updates for ASCs based on outpatient department fee schedules. This amendment will ensure that the copayment for procedures performed in ASCs will not exceed the inpatient hospital deductible amount. This change is significant as it protects beneficiaries from excessive out-of-pocket costs and encourages the use of outpatient surgical services, which are often more efficient and cost-effective than inpatient admissions.
House Bill 972, known as the 'Outpatient Surgery Quality and Access Act of 2023', aims to enhance the payment structures for ambulatory surgical centers (ASCs) under the Medicare program. The bill focuses on modernizing payments, ensuring that updates to ASC payments are aligned with those of outpatient departments in hospitals, thereby enhancing equity in reimbursement for surgical procedures across settings. Additionally, the legislation aims to promote transparency in quality reporting and Medicare beneficiary information, empowering patients to make informed choices regarding their healthcare.
Debates around HB972 highlight concerns about the balance between cost containment and quality of care in healthcare settings. Supporters argue that the alignment of payment updates will improve access to necessary surgical procedures while simultaneously ensuring fair compensation for service providers. However, detractors raise concerns regarding potential reductions in payment levels that may not sufficiently account for the variations in operational costs between different facilities, potentially jeopardizing the sustainability of ASCs, especially in underserved areas.