Legislation Overview

Given the continued fiscal challenges posed by administering health care programs, policymakers and regulators should continue to focus on fostering innovative methods of health care delivery that offer safe, high-quality care so progressive changes in the nation’s health care system can be implemented.

Support should be reserved for those policies that foster competition and promote the utilization of sites of service providing more affordable care, while always maintaining high quality and stringent safety standards. In light of the many benefits ASCs have brought to the nation’s health care system, policymakers should develop and implement payment and coverage policies that increase access to, and utilization of, ASCs.

Ambulatory Surgical Center Quality and Access Act of 2017 (H.R. 1838/S. 1001)

  • The Ambulatory Surgical Center Quality and Access Act of 2017 would move the ASC reimbursement inflationary update from the Consumer Price Index for All Urban Consumers (CPI-U) to the hospital market basket update, which better measures the cost of practicing medicine.

  • This legislation would also require CMS to post similar quality metrics of ASCs and HODPs online in a “side-by-side comparison.” The publicly available data would include quality measures for both sites of service in the same geographic area.

  • Currently, ASCs do not have a voice on the Advisory Panel on Hospital Outpatient Payment, which controls various aspects of physician payment rates. This legislation would add an ASC industry leader to that panel.

  • The bill would also add transparency to the health care industry by requiring the Centers for Medicare & Medicaid Services (CMS) to disclose which criteria they use to deny certain procedures from being performed in an ASC and by requiring them to make publicly available the results of quality reporting measures that apply to both ASCs and HOPDs.

Removing Barriers to Colorectal Cancer Screening Act of 2017 (H.R. 1017/S. 479)

  • Under current law, Medicare waives coinsurance and deductibles for colonoscopies. When a polyp is discovered and removed, the procedure is reclassified as therapeutic for Medicare billing purposes and patients are required to pay the coinsurance. The Removing Barriers to Colorectal Screening Act of 2017 would eliminate unexpected costs for Medicare beneficiaries when a polyp is discovered and removed, ensuring that unexpected copays do not deter a patient from having the screening performed.

  • By eliminating financial barriers, this legislation would attain higher screening rates and reduce the incidence of colorectal cancer.