H.R. 8091 — Outpatient Surgery Access Act of 2026

This section requires the Secretary, in implementing the Medicare ambulatory surgical center (ASC) payment system under SSA section 1833(i)(2)(D)(i), to apply an annual update equal to the outpatient prospective payment system (OPPS) fee schedule increase factor specified in SSA section 1833(t)(3)(C)(iv), adjusted in accordance with clauses (iv) and (v), for 2027 and each subsequent year. (Thus, this aligns ASC payment updates—which cover outpatient surgical procedures performed in ASCs—with OPPS updates for hospital outpatient department services.)

This section prohibits a budget neutrality adjustment specific to ambulatory surgical center (ASC) payments under the revised ASC payment system for 2027 and subsequent years (i.e., an adjustment calibrating aggregate expenditures to the level that would have occurred absent the revised system) and requires budget neutrality adjustments under the hospital outpatient prospective payment system (OPPS) for such years to account for expenditures under the ASC payment system. (As background, ASCs furnish outpatient surgical procedures to Medicare beneficiaries as a lower-cost alternative to hospital outpatient departments; the revised ASC system, implemented in 2017, aligns ASC payments more closely with OPPS site-neutral rates, subject to budget neutrality. Thus, this alignment eliminates the ASC-specific offset while incorporating its expenditures into OPPS adjustments.)