Section 1 Short title
This Act may be cited as the “Medicare Beneficiary Co-Pay Fairness Act”.
Medicare Beneficiary Co-Pay Fairness Act
A BILL
To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.
Sec. 2 Limitation on coinsurance amount
in subsection (a)(1)(G), by inserting “subject to subsection (ee),” before “with respect to facility services”; and
by adding at the end the following new subsection:
“(ee) Limitation on coinsurance amount for certain services furnished in an ambulatory surgical center—In the case that application of subsection (a)(1)(G) would result in the imposition of a coinsurance amount with respect to facility services described in such subsection furnished during a year with respect to a surgical procedure that exceeds the amount of the inpatient hospital deductible established under section 1813(b) for such year, the Secretary shall—
“(1) reduce the amount of such coinsurance to an amount equal to such deductible; and
“(2) pay to the supplier furnishing such services an amount equal to such reduction.”
Effective date— The amendments made by this section shall apply to services furnished on or after January 1, 2026.