II 

114TH CONGRESS 

1ST SESSION S. 2071 

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 

SEPTEMBER 24, 2015 

Mr. CRAPO (for himself, Mr. ALEXANDER, Mr. BLUMENTHAL, and Mr. MURPHY) 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Ambulatory Surgical 

5 Center Quality and Access Act of 2015’’. 


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1 SEC. 2. ALIGNING UPDATES FOR AMBULATORY SURGICAL 

2 CENTER SERVICES WITH UPDATES FOR OPD 

3 SERVICES. 

4 Section 1833(i)(2)(D) of the Social Security Act (42 

5 U.S.C. 1395l(i)(2)(D)) is amended— 

6 (1) in clause (v)— 

7 (A) in the first sentence, by inserting be8 fore the period the following: ‘‘and, in the case 

9 of 2016 or a subsequent year, by the adjust10 ment described in subsection (t)(3)(G) for the 

11 respective year’’; and 

12 (B) by moving the margin 6 ems to the 

13 left; 

14 (2) by redesignating clause (vi) as clause (vii); 

15 and 

16 (3) by inserting after clause (v) the following 

17 new clause: 

18 ‘‘(vi) In implementing the system described in clause 

19 (i) for 2016 and each subsequent year, there shall be an 

20 annual update under such system for the year equal to 

21 the OPD fee schedule increase factor specified under sub22 section (t)(3)(C)(iv) for such year, adjusted in accordance 

23 with clauses (iv) and (v).’’. 


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1 SEC. 3. TRANSPARENCY OF QUALITY REPORTING AND 

2 MEDICARE BENEFICIARY INFORMATION. 

3 Paragraph (7) of section 1833(i) of the Social Secu4 rity Act (42 U.S.C. 1395l(i)) is amended by adding at the 

5 end the following new subparagraphs: 

6 ‘‘(C) To the extent that quality measures imple7 mented by the Secretary under this paragraph for ambula8 tory surgical centers and under section 1833(t)(17) for 

9 hospital outpatient departments are applicable to the pro10 vision of surgical services in both ambulatory surgical cen11 ters and hospital outpatient departments, the Secretary 

12 shall make reported data on such centers and departments 

13 available on the website ‘Medicare.gov’ in a manner that 

14 will permit side-by-side comparisons on such measures for 

15 ambulatory surgical centers and hospital outpatient de16 partments in the same geographic area. 

17 ‘‘(D) For each procedure covered for payment in an 

18 ambulatory surgical center, the Secretary shall publish, 

19 along with the quality reporting comparisons provided for 

20 in subparagraph (C), comparisons of the Medicare pay21 ment and beneficiary copayment amounts for the proce22 dure when performed in ambulatory surgical centers and 

23 hospital outpatient departments in the same geographic 

24 area. 

25 ‘‘(E) The Secretary shall ensure that an ambulatory 

26 surgery center and a hospital has the opportunity to reVerDate Sep 11 2014 02:34 Sep 26, 2015 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2071.IS S2071

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1 view, and submit any corrections for, the data to be made 

2 public with respect to the ambulatory surgery center under 

3 subparagraph (C) prior to such data being made public. 

4 ‘‘(F) The Secretary shall develop materials and in5 form beneficiaries under this title of publicly available 

6 comparisons provided for in subparagraphs (C) and (D).’’. 

7 SEC. 4. ADVISORY PANEL ON HOSPITAL OUTPATIENT PAY8 MENT REPRESENTATION. 

9 (a) ASC REPRESENTATIVE.—The second sentence of 

10 section 1833(t)(9)(A) of the Social Security Act (42 

11 U.S.C. 1395l(t)(9)(A)) is amended by inserting ‘‘and sup12 pliers subject to the prospective payment system (includ13 ing at least one ambulatory surgical center representa14 tive)’’ after ‘‘an appropriate selection of representatives of 

15 providers’’. 

16 (b) EFFECTIVE DATE.—The amendment made by 

17 subsection (a) shall take effect on the date of the enact18 ment of this Act. 

19 SEC. 5. REASONS FOR EXCLUDING ADDITIONAL PROCE20 DURES FROM ASC APPROVED LIST. 

21 (a) IN GENERAL.—Section 1833(i)(1) of the Social 

22 Security Act (42 U.S.C. 1395l(i)(1)) is amended by add23 ing at the end the following: ‘‘In updating such lists for 

24 application in years beginning after the date of the enact25 ment of this sentence, for each procedure that was reVerDate Sep 11 2014 02:34 Sep 26, 2015 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2071.IS S2071

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1 quested to be included in such lists during the public com2 ment period but which the Secretary does not propose (in 

3 the final rule updating such lists) to so include in such 

4 lists, the Secretary shall cite in such final rule the specific 

5 criteria in paragraph (b) or (c) of section 416.166 of title 

6 42, Code of Federal Regulations, based on which the pro7 cedure was excluded. If paragraph (b) of such section is 

8 cited for exclusion of a procedure, the Secretary shall iden9 tify the peer reviewed research or the evidence upon which 

10 such determination is based. The Secretary may not use 

11 or cite section 416.166(c)(7) of such title as criteria or 

12 a basis for exclusion of a procedure from such lists.’’. 

13 (b) EFFECTIVE DATE.—The amendment made by 

14 subsection (a) shall apply to lists of ambulatory surgery 

15 procedures for application in years beginning after the 

16 date of the enactment of this Act. 

Æ 


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