,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hjia  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #be1 #bjbf,ms4   
,van ,duyne 7= h]self & ,mr4 ,l>son (   
,connecticut7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
mod]nize paym5ts = ambulatory surgical  
c5t]s "u ! ,m$ic>e program4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,outpati5t ,surg]y ,access ,act ( #bjbf4
  #b4 ,align+ updates = ambulatory      
surgical c5t] s]vices ) updates = ,,opd 
s]vices ,section #ahcc7;i77#b77;,d7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7i77#b77;,d77 is am5d$--  7#a7 9  
clause 7v71 by mov+ ! m>g9 #f ems to !  
left2  7#b7 by r$esignat+ clause 7vi7 z 
clause 7vii72 &  7#c7 by ins]t+ aft]    

clause 7v7 ! foll[+ new clause3  7vi7 ,9
 implem5t+ ! sy/em describ$ 9 clause 7i7
 = #bjbg & ea* subsequ5t ye>1 !         
,secret>y %all apply an annual update "u
 su* sy/em t is equal to ! ,,opd fee    
s*$ule increase factor specifi$ "u      
subsection 7t77#c77;,c77iv7 = su* ye>1  
adju/$ 9 accordance ) clauses 7iv7 &    
7v74  4  #c4 ,alignm5t ( budget         
neutrality adju/m5t = outpati5t surgical
 proc$ures  7a7  ,prohibit+             
,,asc-,specific budget neutrality       
adju/m5t  ,section                      
#ahcc7;i77#b77;,d77ii7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciel7i77#b77;,d77ii77 is am5d$ by add+
 at ! end ! foll[+ new s5t5ce3 ,9       
implem5t+ su* sy/em = #bjbg & ea*       
subsequ5t ye>1 ! ,secret>y may n apply  
"u su* sy/em any adju/m5t design$ to    
result 9 ! same aggregate am\nt (       
exp5ditures = su* s]vices = ! ye> z w\ld
 be made if ?is subp>agraph did n apply 
7z describ$ 9 ! prec$+ s5t5ce744  7b7   
,comb9+ volume = budget neutrality      

calculation ,section #ahcc7t77#i77;,b7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciel7t77#i77;,b77 is am5d$ by add+ at
 ! end ! foll[+ new s5t5ce3 ,9 det]m9+  
adju/m5ts "u ! fir/ s5t5ce ( ?is        
subp>agraph = #bjbg & ea* subsequ5t ye>1
 ! ,secret>y %all take into acc\nt any  
exp5ditures made "u ! revis$ paym5t     
sy/em "u subsection 7i77#b77;,d744