Bipartisan Senate bill targets ASC Medicare reimbursement gap

Sens. Bill Cassidy, MD, R-La., and Richard Blumenthal, D-Conn., introduced the Outpatient Surgery Access Act of 2026 on July 14, legislation that would require CMS to update ASC Medicare payments using the same inflation factor applied to hospital outpatient rates. 

The bill also would eliminate a budget-neutrality adjustment that ASC advocates say has suppressed reimbursement over time.

The Ambulatory Surgery Center Association endorsed the bill in a July 14 news release shared with Becker’s. “Surgery centers perform millions of essential elective procedures for Medicare beneficiaries every year,” ASCA CEO Bill Prentice said. “Ensuring an accurate and stable payment system is key to increasing patient access to low-cost, high-quality surgery centers.”

Reps. Beth Van Duyne, R-Texas, and John Larson, D-Conn., introduced an identical bill, H.R. 8091, in the House on March 25, giving the effort bipartisan support in both chambers.

CMS aligned ASC and hospital outpatient payment systems in 2009 but has historically updated ASC rates using the Consumer Price Index for All Urban Consumers, rather than the hospital market basket index that accounts for healthcare-specific costs such as wages and malpractice insurance. CMS adopted the hospital market basket for ASCs on a trial basis in 2019; that arrangement expires at the end of 2026.

A KNG Health Consulting analysis cited in the release found ASCs save Medicare more than $5 billion annually and are projected to save $84.8 billion over the next decade, a figure ASCA cited in urging Congress to pass the measure permanently.