Title: ASC Payment Transparency Act of 2018
Policy area: Health

Summary:
Ambulatory Surgical Center Payment Transparency Act of 2018 or ASC Payment Transparency Act of 2018
This bill requires the Centers for Medicare & Medicaid Services (CMS) to specify the criteria used to exclude certain procedures from the list of covered surgical procedures that may be performed in an ambulatory surgical center under Medicare. The CMS may not exclude a procedure on the basis that the procedure can only be reported using an unlisted surgical procedure code.
The bill also requires the expert outside advisory panel that reviews the Medicare prospective payment system for hospital outpatient department services to include at least one ambulatory surgical center representative.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6138 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 6138

    To amend title XVIII of the Social Security Act to provide for 
ambulatory surgical center representation during the review of hospital 
outpatient payment rates under part B of the Medicare program, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 19, 2018

 Mr. Nunes (for himself and Mr. Larson of Connecticut) 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 provide for 
ambulatory surgical center representation during the review of hospital 
outpatient payment rates under part B of 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 Payment 
Transparency Act of 2018'' or the ``ASC Payment Transparency Act of 
2018''.

SEC. 2. 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 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 
apply with respect to advisory panels consulted on or after the date 
that is 1 year after the date of enactment of this Act.

SEC. 3. REASONS FOR EXCLUDING ADDITIONAL PROCEDURES FROM ASC APPROVED 
              LIST.

    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 not 
proposed to be included in such lists in the proposed rule with respect 
to such lists and that was subsequently requested to be included in 
such lists during the public comment period with respect to such 
proposed rule and that is not included in the final rule updating such 
lists, the 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 (or any successor regulation), 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, if any, or the evidence upon which such 
determination is based. The Secretary may not use or cite section 
416.166(c)(7) of such title (or any successor regulation) as criteria 
or a basis for exclusion of a procedure from such lists.''.
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