I 
116TH CONGRESS 
1ST SESSION H. R. 4350 
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 
SEPTEMBER 17, 2019 
Mr. LARSON of Connecticut (for himself and Mr. NUNES) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration 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, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ambulatory Surgical 
Center Quality and Access Act of 2019’’. 
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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 2020 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 2020 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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