Review of the 116th Congress The House and Senate worked through many ASCA priorities this session BY STEVE SELDE

Editor’s note: This is the first part of a two-part column. Look for the second part in the Advocacy Spotlight.

January 2021

The 116th Congress that convened on January 3, 2019, has been a busy and unusual Congress, with active consideration of a

number of healthcare-related issues. ASCA advocated for its members through the first session of the 116th Congress, which ran from January 2019 to January 2020. The second session, which runs January 2020 through Jan- uary 2021, was mostly focused on the federal response to the coronavirus.

First Session of the 116th Congress Throughout the first session, the House and Senate worked through many healthcare issues, including many of ASCA’s priorities.

Medicare for All The new Democratic majority in the House started the Congress off by mak- ing Medicare for All its focus. In the first session, the House majority intro- duced almost a dozen bills that fell under the Medicare for All umbrella. If enacted, these proposals would

have varying impacts on ASCs. Legis- lation under the Medicare for All ban- ner falls into two categories. On one end of the continuum, these bills would prohibit private insurance entirely and leave federally funded and regulated care as the only option. On the other end, some plans would allow private insurance to continue, with new cover- age options offered through the exist- ing Patient Protection and Affordable Care Act (ACA) healthcare exchanges

and options for individuals 50 and over to buy into the Medicare program. The Democratic majority in the House spent the year holding hearings in various committees to further explore these concepts. Ultimately, a Medicare for All bill was not passed by the House in the first session. It seems almost cer- tain that this topic will remain a top pri- ority for progressive Democratic mem- bers and candidates for office.

ASC Quality and Access Act On September 17, 2019, Congressmen Devin Nunes (R-CA) and John Larson (D-CT) introduced the Ambulatory Surgical Center Quality and Access Act in the House. Senators Mike Crapo (R-ID) and Richard Blumenthal (D-CT) introduced companion legisla- tion in the Senate in December 2019. This legislation has four provisions, a few of which have been acted on out- side of the legislative context.

1. Equal Measures: The first pro- vision would require that Medi- care payments to ASCs and hospital outpatient departments


(HOPD) be updated by the same inflationary index. In the calen- dar year 2019 OPPS/ASC final payment rule, the Centers for Medicare & Medicaid Services (CMS) acted to update ASC payments by the hospital market basket, which is used to update payments to HOPDs. The update is for an interim period of five years only. This provision would make this change permanent.

2. Transparent Quality Data: The second provision would require CMS to publish relevant quality data in a way that allows patients to compare quality across sites of service. Currently, Medicare beneficiaries are able to access cost information to compare ASCs to HOPDs. This provi- sion would allow them to review quality information to comple- ment that cost information as they make their choice, in in- stances where they are able, on where they would prefer to have their procedure performed.

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