,,ii  #aaith ,,congress  #b;d ,session  
,s4 #difc  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #ad1     
#bjbf,mr4 ,cassidy introduced the       
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to modernize 
payments for ambulatory surgical centers
 under the ,medicare program4  #a4      
,short title ,this ,act may be cited as 
the ,outpatient ,surgery ,access ,act of
 #bjbf4  #b4 ,aligning updates for      
ambulatory surgical center services with
 updates for ,,opd services ,section    
#ahcc7;i77#b77;,d7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#aciel7i77#b77;,d77 is amended-- 7#a7 in
 clause 7v71 by moving the margin #f ems
 to the left2  7#b7 by redesignating    
clause 7vi7 as clause 7vii72 and  7#c7  
by inserting after clause 7v7 the       
following new clause3  7vi7 ,in         
implementing the system described in    
clause 7i7 for #bjbg and each subsequent

 year1 the ,secretary shall apply an    
annual update under such system that is 
equal to the ,,opd fee schedule increase
 factor specified under subsection      
7t77#c77;,c77iv7 for such year1 adjusted
 in accordance with clauses 7iv7 and    
7v74  4  #c4 ,alignment of budget       
neutrality adjustment for outpatient    
surgical procedures  7a7 ,prohibiting   
,,asc-,specific budget neutrality       
adjustment ,section                     
#ahcc7;i77#b77;,d77ii7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#aciel7i77#b77;,d77ii77 is amended by   
adding at the end the following new     
sentence3 ,in implementing such system  
for #bjbg and each subsequent year1 the 
,secretary may not apply under such     
system any adjustment designed to result
 in the same aggregate amount of        
expenditures for such services for the  
year as would be made if this           
subparagraph did not apply 7as described
 in the preceding sentence744  7b7      
,combining volume for budget neutrality 

calculation ,section #ahcc7t77#i77;,b7  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #aciel7t77#i77;,b77 is amended
 by adding at the end the following new 
sentence3 ,in determining adjustments   
under the first sentence of this        
subparagraph for #bjbg and each         
subsequent year1 the ,secretary shall   
take into account any expenditures made 
under the revised payment system under  
subsection 7i77#b77;,d744