Title: Ambulatory Surgical Center Quality and Access Act of 2017
Policy area: Health

Summary:
Ambulatory Surgical Center Quality and Access Act of 2017
This bill amends title XVIII (Medicare) of the Social Security Act to: (1) require the payment system for ambulatory surgical center (ASC) services to feature certain positive annual adjustments equivalent to those made with respect to hospital outpatient department (OPD) services; (2) revise quality reporting requirements to permit publicly available, side-by-side comparisons of quality measures for ASCs and OPDs in the same geographic area; and (3) require the Department of Health and Human Services (HHS), when excluding requested procedures from the list of those approved to be performed in ASCs, to cite specified reasons for doing so.
With respect to excluding procedures from the approved list for ASCs, HHS may not cite as a basis for exclusion that a procedure can only be reported using an unlisted surgical procedure code. (Physicians sometimes use unlisted codes when performing new procedures or services if no existing code is adequately descriptive.)

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1838 Introduced in House (IH)]

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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. Blackburn, 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. Sanchez, 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 committee 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 Representatives 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 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 before the 
                period the following: ``and, in the case of 2018 or a 
                subsequent year, by the adjustment 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 subsection (t)(3)(C)(iv) for such year, adjusted in 
accordance with clauses (iv) and (v).''.

SEC. 3. TRANSPARENCY OF QUALITY REPORTING AND MEDICARE BENEFICIARY 
              INFORMATION.

    Paragraph (7) of section 1833(i) of the Social Security 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 implemented by the 
Secretary under this paragraph for ambulatory surgical centers and 
under section 1833(t)(17) for hospital outpatient departments are 
applicable to the provision of surgical services in both ambulatory 
surgical centers 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 departments in the same geographic area.
    ``(D) The Secretary shall ensure that an ambulatory surgery center 
and a hospital has the opportunity to review, 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 inform 
beneficiaries under this title of publicly available comparisons 
provided for in subparagraph (C).''.

SEC. 4. ADVISORY PANEL ON HOSPITAL OUTPATIENT PAYMENT 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 suppliers subject to the prospective payment 
system (including at least one ambulatory surgical center 
representative)'' 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 enactment of this Act.

SEC. 5. REASONS FOR EXCLUDING ADDITIONAL PROCEDURES 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 adding at the end the following: ``In 
updating such lists for application in years beginning after the date 
of the enactment of this sentence, for each procedure that was 
requested to be included in such lists during the public comment 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 criteria in paragraph (b) or (c) of section 
416.166 of title 42, Code of Federal Regulations, based on which the 
procedure was excluded. If paragraph (b) of such section is cited for 
exclusion of a procedure, the Secretary shall identify 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.
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