Representatives Devin Nunes and John Larson Launch Bipartisan Effort to Increase Medicare Reimbursement to Ambulatory Surgical Centers

Recently, Reps. Devin Nunes (R-CA) and John Larson (D-CT) introduced the Ambulatory Surgical Center Quality and Access Act of 2017 (H.R. 1838) to update Medicare reimbursement for ambulatory surgical center (ASC) services using the same update factor as hospital outpatient departments (HOPDs). On average, Medicare currently pays ASCs less than 50% of HOPD rates for the same procedure, partly because ASC payment rates are updated using the Consumer Price Index for All Urban Consumers (CPI-U), whereas HOPD payment increases are based on the hospital market basket, which includes the total cost of all the goods and services the hospital must buy to provide care and takes inflation into account. H.R. 1838 would update ASC payments to use the same mechanism as HOPDs, since there are no significant differences in the cost of goods and services provided by ASCs and HOPDs.

In addition to introducing the legislation, Reps. Nunes and Larson drafted a letter to Health and Human Services Secretary Tom Price, MD, asking him to use his statutory authority to move ASCs from the CPI-U to the hospital market basket. The two Congressmen are currently circulating the letter to their colleagues in the House asking for cosigners.

We will keep you updated.