Ambulatory Surgical Center Quality and Access Act of 2019

II 116TH CONGRESS 1ST SESSION S. 3085 To amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program, and for other purposes. IN THE SENATE OF THE UNITED STATES DECEMBER 18, 2019 Mr. CRAPO (for himself and Mr. BLUMENTHAL) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Ambulatory Surgical 4 Center Quality and Access Act of 2019’’. 5 VerDate Sep 11 2014 04:15 Dec 21, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3085.IS S3085 kjohnson on DSK79L0C42 with BILLS 2 •S 3085 IS SEC. 2. ALIGNING UPDATES FOR AMBULATORY SURGICAL 1 CENTER SERVICES WITH UPDATES FOR OPD 2 SERVICES. 3 Section 1833(i)(2)(D) of the Social Security Act (42 4 U.S.C. 1395l(i)(2)(D)) is amended— 5 (1) in clause (v)— 6 (A) in the first sentence, by inserting be- 7 fore the period the following: ‘‘and, in the case 8 of 2020 or a subsequent year, by the adjust- 9 ment described in subsection (t)(3)(G) for the 10 respective year’’; and 11 (B) by moving the margin 6 ems to the 12 left; 13 (2) by redesignating clause (vi) as clause (vii); 14 and 15 (3) by inserting after clause (v) the following 16 new clause: 17 ‘‘(vi) In implementing the system described in clause 18 (i) for 2020 and each subsequent year, there shall be an 19 annual update under such system for the year equal to 20 the OPD fee schedule increase factor specified under sub- 21 section (t)(3)(C)(iv) for such year, adjusted in accordance 22 with clauses (iv) and (v).’’. 23 VerDate Sep 11 2014 04:15 Dec 21, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3085.IS S3085 kjohnson on DSK79L0C42 with BILLS 3 •S 3085 IS SEC. 3. TRANSPARENCY OF QUALITY REPORTING AND 1 MEDICARE BENEFICIARY INFORMATION. 2 Paragraph (7) of section 1833(i) of the Social Secu- 3 rity Act (42 U.S.C. 1395l(i)) is amended by adding at the 4 end the following new subparagraphs: 5 ‘‘(C) To the extent that quality measures imple- 6 mented by the Secretary under this paragraph for ambula- 7 tory surgical centers and under section 1833(t)(17) for 8 hospital outpatient departments are applicable to the pro- 9 vision of surgical services in both ambulatory surgical cen- 10 ters and hospital outpatient departments, the Secretary 11 shall make reported data on such centers and departments 12 available on the website ‘Medicare.gov’ in a manner that 13 will permit side-by-side comparisons on such measures for 14 ambulatory surgical centers and hospital outpatient de- 15 partments in the same geographic area. 16 ‘‘(D) The Secretary shall ensure that an ambulatory 17 surgery center and a hospital has the opportunity to re- 18 view, and submit any corrections for, the data to be made 19 public with respect to the ambulatory surgery center under 20 subparagraph (C) prior to such data being made public. 21 ‘‘(E) The Secretary shall develop materials and in- 22 form beneficiaries under this title of publicly available 23 comparisons provided for in subparagraph (C).’’. 24 VerDate Sep 11 2014 04:15 Dec 21, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3085.IS S3085 kjohnson on DSK79L0C42 with BILLS 4 •S 3085 IS SEC. 4. ADVISORY PANEL ON HOSPITAL OUTPATIENT PAY- 1 MENT REPRESENTATION. 2 (a) ASC REPRESENTATIVE.—The second sentence of 3 section 1833(t)(9)(A) of the Social Security Act (42 4 U.S.C. 1395l(t)(9)(A)) is amended by inserting ‘‘and sup- 5 pliers subject to the prospective payment system (includ- 6 ing at least one ambulatory surgical center representa- 7 tive)’’ after ‘‘an appropriate selection of representatives of 8 providers’’. 9 (b) EFFECTIVE DATE.—The amendment made by 10 subsection (a) shall take effect on the date of the enact- 11 ment of this Act. 12 SEC. 5. REASONS FOR EXCLUDING ADDITIONAL PROCE- 13 DURES FROM ASC APPROVED LIST. 14 (a) IN GENERAL.—Section 1833(i)(1) of the Social 15 Security Act (42 U.S.C. 1395l(i)(1)) is amended by add- 16 ing at the end the following: ‘‘In updating such lists for 17 application in years beginning after the date of the enact- 18 ment of this sentence, for each procedure that was re- 19 quested to be included in such lists during the public com- 20 ment period but which the Secretary does not propose (in 21 the final rule updating such lists) to so include in such 22 lists, the Secretary shall cite in such final rule the specific 23 criteria in paragraph (b) or (c) of section 416.166 of title 24 42, Code of Federal Regulations, based on which the pro- 25 cedure was excluded. If paragraph (b) of such section is 26 VerDate Sep 11 2014 04:15 Dec 21, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3085.IS S3085 kjohnson on DSK79L0C42 with BILLS 5 •S 3085 IS cited for exclusion of a procedure, the Secretary shall iden- 1 tify the peer reviewed research or the evidence upon which 2 such determination is based.’’. 3 (b) EFFECTIVE DATE.—The amendment made by 4 subsection (a) shall apply to lists of ambulatory surgery 5 procedures for application in years beginning after the 6 date of the enactment of this Act. 7 Æ VerDate Sep 11 2014 04:15 Dec 21, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S3085.IS S3085 kjohnson on DSK79L0C42 with BILLS