Us Congress House Bill HB3006

Us Congress 2025-2026 Regular Session

• Introduced: 4/24/25
• Refer: 4/24/25

Caption

To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.

Impact

The provisions of HB3006 mandate that if the calculated coinsurance amount exceeds the inpatient hospital deductible established for a particular year, the patient’s payment responsibility will be capped at that deductible level. This change is expected to apply to services furnished on or after January 1, 2026, allowing for adjustments in billing and collections practices in anticipation of the new law. By standardizing the coinsurance across surgical services provided at ASCs, the bill aims to promote fairness and access, particularly for surgical treatments that do not necessitate an overnight hospital stay.

Summary

House Bill 3006 introduces amendments to Title XVIII of the Social Security Act, specifically aimed at limiting the coinsurance amounts that patients are required to pay for certain services provided in ambulatory surgical centers (ASCs). The overarching goal of the bill is to make healthcare more affordable for individuals undergoing surgical procedures by significantly reducing their financial burden at point-of-service. This reform is particularly pertinent given rising health costs and the financial strain that medical expenses can impose on patients and their families.

Contention

While the bill seeks to enhance patient accessibility to surgical services, it may also raise concerns about potential implications for ASC funding and operational viability. Critics could argue that placing limits on coinsurance could result in lower reimbursement rates for facilities, affecting their ability to provide a broad range of services or maintain quality standards. Furthermore, the bill might provoke debate about the necessity and appropriateness of government intervention in regulating coinsurance structures when many insurers have been shifting towards value-based care models.