Medicare Beneficiary Co-Pay Fairness Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
This bill, the Medicare Beneficiary Co-Pay Fairness Act, aims to ensure fairer co-payments for Medicare beneficiaries receiving services at ambulatory surgical centers. Specifically, it limits the coinsurance amount for these services to match the inpatient hospital deductible for the year. This change is intended to reduce out-of-pocket costs for patients undergoing surgical procedures at these facilities. The bill takes effect on January 1, 2026.
Key provisions
- Limits Medicare coinsurance for ambulatory surgical center services.
- Sets the coinsurance amount equal to the inpatient hospital deductible.
- Provides a payment to the surgical center for the difference between the original coinsurance and the deductible amount.
Who is affected
- Medicare beneficiaries
- Ambulatory surgical centers
- The Centers for Medicare & Medicaid Services (CMS)
Notable changes
- Changes the way Medicare calculates coinsurance for facility services at ambulatory surgical centers.
Fiscal impact
The bill may result in reduced payments to ambulatory surgical centers and a shift in Medicare spending.
Bill text
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Sponsors
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2 on record
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Cosponsor
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