ASCA works with the United States Congress to ensure sound public policy concerning ASCs and their Medicare patients is implemented. Because ASCs provide superior quality and timely patient care, the ASC community must work with Congress to ensure Medicare patients continue to have access to ASCs.
2025-2026 Legislative Priorities
The 119th Congress convened in January 2025, and ASCA is actively collaborating with stakeholders, ASC advocates and congressional leaders to advance key federal legislative priorities this session. A primary focus is the introduction and passage of the Medicare Beneficiary Co-Pay Fairness Act (H.R. 3006/S.1776), legislation that addresses the copay penalty experienced by Medicare beneficiaries when seeking care at an ASC. This critical legislation aims to ensure Medicare Part B patients pay the same maximum out-of-pocket amount ($1,736 for 2026, equivalent to the current hospital inpatient deductible) when receiving the same services in an ASC as they would in a hospital outpatient department (HOPD). In HOPDs, the 20 percent copay is already capped at the hospital inpatient deductible amount.
A coalition of 49 leading healthcare organizations support passage of the Medicare Beneficiary Co-Pay Fairness Act, with letters of support submitted to the House Committees on Energy & Commerce and Ways & Means, and the Senate Committees on Finance and Health, Education, Labor & Pensions (HELP).
ASCA has also introduced the Outpatient Surgery Access Act of 2026 (H.R. 8091), legislation that addresses Medicare’s annual inflationary update and the use of the secondary weight scalar in the ASC payment system. This legislation would make permanent the 2019 decision by the U.S. Department of Health and Human Services to use the same update factor for HOPDS and ASCs, allowing ASC payments to keep pace with inflation. Additionally, the legislation would end the use of the secondary scalar in the ASC payment system, which decreases ASC reimbursements as procedure volume grows and prevents ASCs from generating even greater savings for the Medicare program.
For comprehensive information regarding ASCA’s legislative priorities, please contact David Opong-Wadee at dopongwadee@ascassociation.org.
You can help gain support for the Medicare Beneficiary Co-Pay Fairness Act by using ASCA’s template letter to reach out to your lawmakers and ask them to sign on to the bill as a cosponsor.