Section 1 Short title
This Act may be cited as the “Outpatient Surgery Access Act of 2026”.
Outpatient Surgery Access Act of 2026
A BILL
To amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program.
Sec. 2 Aligning updates for ambulatory surgical center services with updates for OPD services
Section 1833(i)(2)(D) of the Social Security Act (42 U.S.C. 1395l(i)(2)(D)) is amended—
in clause (v), by moving the margin 6 ems to the left;
by redesignating clause (vi) as clause (vii); and
by inserting after clause (v) the following new clause:
“(vi) In implementing the system described in clause (i) for 2027 and each subsequent year, the Secretary shall apply an annual update under such system that is equal to the OPD fee schedule increase factor specified under subsection (t)(3)(C)(iv) for such year, adjusted in accordance with clauses (iv) and (v).”
Sec. 3 Alignment of budget neutrality adjustment for outpatient surgical procedures
Prohibiting ASC-Specific budget neutrality adjustment— Section 1833(i)(2)(D)(ii) of the Social Security Act (42 U.S.C. 1395l(i)(2)(D)(ii)) is amended by adding at the end the following new sentence: “In implementing such system for 2027 and each subsequent year, the Secretary may not apply under such system any adjustment designed to result in the same aggregate amount of expenditures for such services for the year as would be made if this subparagraph did not apply (as described in the preceding sentence).”.
Combining volume for budget neutrality calculation— Section 1833(t)(9)(B) of the Social Security Act (42 U.S.C. 1395l(t)(9)(B)) is amended by adding at the end the following new sentence: “In determining adjustments under the first sentence of this subparagraph for 2027 and each subsequent year, the Secretary shall take into account any expenditures made under the revised payment system under subsection (i)(2)(D).”.