Outpatient Surgery Access Act of 2026
- Bill Number
- H.R. 8091
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-25: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-04-13T19:06:58Z
AI-Generated Summary
Outpatient Surgery Access Act of 2026 (H.R. 8091)
Purpose
The bill aims to modernize Medicare payments for services provided by ambulatory surgical centers (ASCs)—freestanding facilities that perform outpatient surgeries—by aligning their payment updates and budget adjustments with those for hospital outpatient department (OPD) services, starting in 2027.
Key Provisions
- Annual Payment Updates (Section 2): Requires the Secretary of Health and Human Services (who oversees Medicare via the Centers for Medicare & Medicaid Services, or CMS) to apply the same annual update factor to ASC payments as used for OPD services under the Outpatient Prospective Payment System (OPPS). This factor is adjusted for inflation and other factors.
- Budget Neutrality Adjustments (Section 3):
- Prohibits separate budget neutrality adjustments specific to ASCs (budget neutrality means scaling payments so total spending stays roughly the same as without changes).
- Requires ASC expenditures to be included when calculating budget neutrality for OPD payments.
Significant Changes to Existing Law
- Amends Section 1833(i)(2)(D) and Section 1833(t)(9)(B) of the Social Security Act (Title XVIII, which governs Medicare Part B).
- Shifts ASCs from independent update mechanisms and budget neutrality calculations to ones synchronized with hospital OPD services, eliminating ASC-specific spending caps starting in 2027.
- Technical tweaks to clause numbering for clarity.
Potential Impacts
- Government Agencies: CMS must implement new payment calculations, potentially increasing administrative workload but simplifying alignment between ASC and OPD systems.
- Citizens (Medicare Beneficiaries): Could improve access to lower-cost outpatient surgeries at ASCs, as payments may rise to match hospital rates, encouraging more procedures outside expensive hospitals.
- Fiscal: May increase overall Medicare spending on ASC services without dedicated offsets, as budget neutrality is now shared with OPD.
- Healthcare Delivery: Promotes competition between ASCs and hospitals for outpatient procedures.
Main Stakeholders Affected
- ASC Operators and Providers: Primary beneficiaries, gaining payment parity with hospitals.
- Medicare Beneficiaries: Gain potential for more surgery options at efficient sites.
- Hospitals (OPD Services): Face indirect pressure from combined budget neutrality, which includes ASC spending.
- Taxpayers and Medicare Trust Fund: Possible higher expenditures without corresponding savings elsewhere.
- CMS: Responsible for execution and rulemaking.
Notable Legal, Constitutional, or Political Implications
- Legal: Relies on CMS's existing authority under the Social Security Act; no new mandates beyond specified adjustments, reducing litigation risk.
- Fiscal/Political: Introduces spending changes without explicit budget offsets, which could spark debates in Congress over Medicare solvency amid rising healthcare costs. Bipartisan sponsors (Reps. Van Duyne and Larson) suggest broad appeal for modernizing payments. No direct constitutional issues, as it pertains to congressional spending power under Medicare.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Van Duyne, Beth [R-TX-24]
Cosponsors (1)
Recent Actions
- 2026-03-25: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-25: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-25: Introduced in House
- 2026-03-25: Introduced in House
Bill Versions
- Outpatient Surgery Access Act of 2026 — issued 2026-03-25 — PDF (3 pages)