ASC Payment Transparency Act of 2018

Bill: 115-hr-6138
Sponsor: full_name: Rep. Nunes, Devin [R-CA-22]
Introduced: 2018-06-19
Policy area: Health
Subjects: Advisory bodies

Health care coverage and access

Home and outpatient care

Medicare

Surgery and anesthesia
Latest action: action_date: 2018-07-25
text: Received in the Senate and Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2018-06-19
action_desc: Introduced in House
text: <p><b>Ambulatory Surgical Center Payment Transparency Act of 2018 or ASC Payment Transparency Act of 2018</b></p> <p>This bill requires the Centers for Medicare &amp; 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. </p> <p>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. </p>

action_date: 2018-07-17
action_desc: Reported to House amended, Part I
text: <p><b>Ambulatory Surgical Center Payment Transparency Act of 2018 or ASC Payment Transparency Act of 2018</b></p> <p>This bill requires the Centers for Medicare &amp; 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. </p> <p>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. </p>

action_date: 2018-07-24
action_desc: Passed House amended
text: <p><b>Ambulatory Surgical Center Payment Transparency Act of 2018 or ASC Payment Transparency Act of 2018</b></p> <p>(Sec. 2) This bill 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. </p> <p>(Sec. 3) The bill also requires the Centers for Medicare &amp; Medicaid Services 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. </p>

tv_txt: I 115th CONGRESS 2d Session H. R. 6138 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.

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 . 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. 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. .

tv_txt: I 115th CONGRESS 2d Session H. R. 6138 IN THE HOUSE OF REPRESENTATIVES AN ACT 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.

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 . 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. 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 with the second year 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. .

Passed the House of Representatives July 24, 2018. Karen L. Haas, Clerk.

tv_txt: IB Union Calendar No. 643 115th CONGRESS 2d Session H. R. 6138 [Report No. 115–831, Part I] 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 July 17, 2018 Additional sponsors: Mr. Gohmert and Mr. Lance July 17, 2018 Reported from the Committee on Ways and Means with an amendment Strike out all after the enacting clause and insert the part printed in italic July 17, 2018 Committee on Energy and Commerce discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed For text of introduced bill, see copy of bill as introduced on June 19, 2018 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.

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 . 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. 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 with the second year 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. .

July 17, 2018 Reported from the Committee on Ways and Means with an amendment July 17, 2018 Committee on Energy and Commerce discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed

tv_txt: IIB 115th CONGRESS 2d Session H. R. 6138 IN THE SENATE OF THE UNITED STATES July 25, 2018 Received; read twice and referred to the Committee on Finance AN ACT 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.

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 . 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. 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 with the second year 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. .

Passed the House of Representatives July 24, 2018. Karen L. Haas, Clerk