# Understanding the Outpatient Surgery Quality and Access Act of 2023

This bill makes changes to how Medicare pays for surgical procedures performed at ambulatory surgical centers—these are specialized facilities where patients have surgery and go home the same day, rather than staying overnight in a hospital. The main goal is to make the payment system fairer and more transparent for these outpatient surgery centers and to give patients better information when choosing where to have their procedures done.

The bill addresses payment updates by aligning how ambulatory surgical centers get paid with how hospital outpatient departments get paid. Currently, these two types of facilities use different payment formulas, which can create inconsistencies. Starting in 2024, ambulatory surgical centers will receive the same annual payment increases that hospital outpatient departments receive, making the system more uniform. The bill also caps what Medicare patients have to pay out-of-pocket for procedures at ambulatory surgical centers—their copayment can't exceed the annual hospital deductible amount, which gives patients a clearer limit on their costs.

On the transparency side, the bill requires Medicare to publish quality and safety data for both ambulatory surgical centers and hospital outpatient departments on Medicare.gov in a way that lets patients compare them side-by-side in their area. This means if you're deciding where to have a procedure, you'll be able to see how different facilities perform on quality measures. The bill also ensures that ambulatory surgical centers have a voice in Medicare's advisory panel that makes decisions about which procedures can be done in these facilities, and it requires the government to explain in writing why certain procedures are excluded from being performed at ambulatory surgical centers, backed up by research evidence.

Outpatient Surgery Quality and Access Act of 2023

Wenstrup, Brad R.

Outpatient Surgery Quality and Access Act of 2023 This bill establishes and modifies certain requirements relating to Medicare payments for ambulatory surgical center (ASC) services. Specifically, the bill (1) requires the payment system for ASC services to feature certain positive annual adjustments equivalent to those made with respect to hospital outpatient department (OPD) services; (2) revises quality reporting requirements to&nbsp;permit publicly available, side-by-side comparisons of quality measures for ASCs and OPDs in the same geographic area; and (3) requires the Centers for Medicare &amp; Medicaid Services (CMS), when excluding&nbsp;requested procedures from the list of those approved to be performed in ASCs, to cite specified reasons for doing so. With respect to excluding procedures from the approved list for ASCs, the CMS may not cite as a basis for exclusion that a procedure can only be reported using an unlisted surgical procedure code.&nbsp;(Physicians sometimes use unlisted codes when performing new procedures or services if no existing code is adequately descriptive.) The bill also limits the copayment amount for ASC services under Medicare to that of the inpatient hospital deductible.