Medicare to pay ambulatory surgery centers more, removing cost controls
H.R. 8091 — Outpatient Surgery Access Act of 2026 · Filed by Beth Van Duyne (R-TX) · 1 cosponsor · Introduced Mar 25, 2026 · Referred to committee
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What it does
This bill changes how Medicare pays ambulatory surgical centers (ASCs)—outpatient surgery facilities—starting in 2027. Instead of using a separate payment formula, ASCs will receive the same annual payment increase that hospital outpatient departments (OPDs) get, and Medicare will no longer apply a separate budget-neutrality adjustment that currently holds ASC spending flat. The effect is to align ASC payment growth with OPD payment growth and remove a cost-control mechanism specific to ASCs.
Why we flagged it
The bill's operative mechanism is a reimbursement increase for a specific healthcare provider category (ASCs) by aligning their payment updates with a higher-growth benchmark and removing a cost-control mechanism. This is a targeted payment policy favoring ASC providers.
What the text implies
- Removing budget neutrality adjustment means ASC spending is no longer constrained to a fixed total—spending can grow without offsetting reductions elsewhere in the Medicare program, increasing overall program costs.
- Combining ASC volume with OPD volume for budget neutrality calculation may dilute the budget-control effect across a larger service base, further reducing cost containment.
The full analysis lists 3 implications of this text.
Who stands to gain
ambulatory surgical centers (ASC operators and owners); healthcare providers operating outpatient surgery facilities