Legis Daily

To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.

USA119th CongressHR-3006| House 
| Updated: 4/24/2025
Mike Kelly

Mike Kelly

Republican Representative

Pennsylvania

Cosponsors (21)
Adrian Smith (Republican)Marc A. Veasey (Democratic)Robert Menendez (Democratic)Terri A. Sewell (Democratic)Janelle S. Bynum (Democratic)Michael A. Rulli (Republican)Ted Lieu (Democratic)Rudy Yakym (Republican)John B. Larson (Democratic)Carol D. Miller (Republican)John Joyce (Republican)John H. Rutherford (Republican)Joe Neguse (Democratic)Mike Bost (Republican)Sarah McBride (Democratic)Deborah K. Ross (Democratic)Burgess Owens (Republican)Josh Gottheimer (Democratic)Rashida Tlaib (Democratic)Tracey Mann (Republican)Troy Balderson (Republican)

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This bill proposes an amendment to Title XVIII of the Social Security Act, specifically targeting Medicare's cost-sharing structure for services rendered in ambulatory surgical centers (ASCs) . Its primary goal is to establish a limitation on the coinsurance amount that beneficiaries pay for certain facility services provided in these centers. Under the proposed change, if a beneficiary's coinsurance for a surgical procedure in an ASC would exceed the annual inpatient hospital deductible , the Secretary of Health and Human Services would be required to reduce that coinsurance to match the deductible amount. The bill also stipulates that the supplier furnishing the services would receive an amount equal to this reduction. These amendments are slated to take effect for services furnished on or after January 1, 2026 , aiming to mitigate potentially high out-of-pocket expenses for Medicare beneficiaries utilizing ASCs.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Apr 24, 2025
Introduced in House
Apr 24, 2025
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.
  • April 24, 2025
    Introduced in House


  • April 24, 2025
    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.

Health

Related Bills

  • S 119-1776: Medicare Beneficiary Co-Pay Fairness Act

To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.

USA119th CongressHR-3006| House 
| Updated: 4/24/2025
This bill proposes an amendment to Title XVIII of the Social Security Act, specifically targeting Medicare's cost-sharing structure for services rendered in ambulatory surgical centers (ASCs) . Its primary goal is to establish a limitation on the coinsurance amount that beneficiaries pay for certain facility services provided in these centers. Under the proposed change, if a beneficiary's coinsurance for a surgical procedure in an ASC would exceed the annual inpatient hospital deductible , the Secretary of Health and Human Services would be required to reduce that coinsurance to match the deductible amount. The bill also stipulates that the supplier furnishing the services would receive an amount equal to this reduction. These amendments are slated to take effect for services furnished on or after January 1, 2026 , aiming to mitigate potentially high out-of-pocket expenses for Medicare beneficiaries utilizing ASCs.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Apr 24, 2025
Introduced in House
Apr 24, 2025
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.
  • April 24, 2025
    Introduced in House


  • April 24, 2025
    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.
Mike Kelly

Mike Kelly

Republican Representative

Pennsylvania

Cosponsors (21)
Adrian Smith (Republican)Marc A. Veasey (Democratic)Robert Menendez (Democratic)Terri A. Sewell (Democratic)Janelle S. Bynum (Democratic)Michael A. Rulli (Republican)Ted Lieu (Democratic)Rudy Yakym (Republican)John B. Larson (Democratic)Carol D. Miller (Republican)John Joyce (Republican)John H. Rutherford (Republican)Joe Neguse (Democratic)Mike Bost (Republican)Sarah McBride (Democratic)Deborah K. Ross (Democratic)Burgess Owens (Republican)Josh Gottheimer (Democratic)Rashida Tlaib (Democratic)Tracey Mann (Republican)Troy Balderson (Republican)

Ways and Means Committee, Energy and Commerce Committee

Health

Related Bills

  • S 119-1776: Medicare Beneficiary Co-Pay Fairness Act
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted