I 
115TH CONGRESS 
1ST SESSION H. R. 1838 
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 HOUSE OF REPRESENTATIVES 
MARCH 30, 2017 
Mr. NUNES (for himself, Mr. LARSON of Connecticut, Mr. STEWART, Mr. 
SCHWEIKERT, Mr. GARAMENDI, Mr. SMITH of Washington, Mrs. BLACK-
BURN, Mr. LAMBORN, Mr. VEASEY, Mr. TIPTON, Mr. YOUNG of Alaska, 
Mr. SESSIONS, Mr. ROE of Tennessee, Mrs. WALORSKI, Mr. NORCROSS, 
Mr. PASCRELL, Mr. BUCSHON, Mr. HENSARLING, Ms. SA´NCHEZ, Mr. 
LANCE, Mr. STIVERS, Mr. SWALWELL of California, Mr. DAVID SCOTT 
of Georgia, Ms. JENKINS of Kansas, Mr. LOEBSACK, Mr. KILDEE, Mr. 
PETERS, Mr. FARENTHOLD, and Mr. SAM JOHNSON of Texas) introduced 
the following bill; which was 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 com-
mittee concerned 
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-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ambulatory Surgical 
Center Quality and Access Act of 2017’’. 
SEC. 2. ALIGNING UPDATES FOR AMBULATORY SURGICAL 
CENTER SERVICES WITH UPDATES FOR OPD 
SERVICES. 
Section 1833(i)(2)(D) of the Social Security Act (42 
U.S.C. 1395l(i)(2)(D)) is amended— 
(1) in clause (v)— 
(A) in the first sentence, by inserting be-
fore the period the following: ‘‘and, in the case 
of 2018 or a subsequent year, by the adjust-
ment described in subsection (t)(3)(G) for the 
respective year’’; and 
(B) by moving the margin 6 ems to the 
left; 
(2) by redesignating clause (vi) as clause (vii); 
and 
(3) by inserting after clause (v) the following 
new clause: 
‘‘(vi) In implementing the system described in clause 
(i) for 2018 and each subsequent year, there shall be an 
annual update under such system for the year equal to 
the OPD fee schedule increase factor specified under sub-
section (t)(3)(C)(iv) for such year, adjusted in accordance 
with clauses (iv) and (v).’’. 
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SEC. 3. TRANSPARENCY OF QUALITY REPORTING AND 
MEDICARE BENEFICIARY INFORMATION. 
Paragraph (7) of section 1833(i) of the Social Secu-
rity Act (42 U.S.C. 1395l(i)) is amended by adding at the 
end the following new subparagraphs: 
‘‘(C) To the extent that quality measures imple-
mented by the Secretary under this paragraph for ambula-
tory surgical centers and under section 1833(t)(17) for 
hospital outpatient departments are applicable to the pro-
vision of surgical services in both ambulatory surgical cen-
ters and hospital outpatient departments, the Secretary 
shall make reported data on such centers and departments 
available on the website ‘Medicare.gov’ in a manner that 
will permit side-by-side comparisons on such measures for 
ambulatory surgical centers and hospital outpatient de-
partments in the same geographic area. 
‘‘(D) The Secretary shall ensure that an ambulatory 
surgery center and a hospital has the opportunity to re-
view, and submit any corrections for, the data to be made 
public with respect to the ambulatory surgery center under 
subparagraph (C) prior to such data being made public. 
‘‘(E) The Secretary shall develop materials and in-
form beneficiaries under this title of publicly available 
comparisons provided for in subparagraph (C).’’. 
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SEC. 4. ADVISORY PANEL ON HOSPITAL OUTPATIENT PAY-
MENT REPRESENTATION. 
(a) ASC REPRESENTATIVE.—The second sentence of 
section 1833(t)(9)(A) of the Social Security Act (42 
U.S.C. 1395l(t)(9)(A)) is amended by inserting ‘‘and sup-
pliers subject to the prospective payment system (includ-
ing at least one ambulatory surgical center representa-
tive)’’ after ‘‘an appropriate selection of representatives of 
providers’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the date of the enact-
ment of this Act. 
SEC. 5. REASONS FOR EXCLUDING ADDITIONAL PROCE-
DURES FROM ASC APPROVED LIST. 
(a) IN GENERAL.—Section 1833(i)(1) of the Social 
Security Act (42 U.S.C. 1395l(i)(1)) is amended by add-
ing at the end the following: ‘‘In updating such lists for 
application in years beginning after the date of the enact-
ment of this sentence, for each procedure that was re-
quested to be included in such lists during the public com-
ment period but which the Secretary does not propose (in 
the final rule updating such lists) to so include in such 
lists, Secretary shall cite in such final rule the specific cri-
teria in paragraph (b) or (c) of section 416.166 of title 
42, Code of Federal Regulations, based on which the pro-
cedure was excluded. If paragraph (b) of such section is 
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cited for exclusion of a procedure, the Secretary shall iden-
tify the peer reviewed research or the evidence upon which 
such determination is based. The Secretary may not use 
or cite section 416.166(c)(7) of such title as criteria or 
a basis for exclusion of a procedure from such lists.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to lists of ambulatory surgery 
procedures for application in years beginning after the 
date of the enactment of this Act. 
Æ 
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