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House Committee on Energy and CommerceHealthHouse Committee on Ways and MeansHealthIntroducedJune 25th, 2013
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Ambulatory Surgical Center Quality and Access Act of 2013
To amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program, and for other purposes.
Ambulatory Surgical Center Quality and Access Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to require alignment of updates for ambulatory surgical center (ASC) services under a revised prospective payment system (PPS) with updates for hospital outpatient department (OPD) services. Revises requirements for the reporting and applying of quality measure data by ASCs and hospital OPDs. Directs the Secretary of Health and Human Services (HHS) to establish an ASC value-based purchasing program under which each ASC that the Secretary determines meets (or exceeds) performance standards established, with respect to selected quality measures, for the performance period for a calendar year is eligible for shared savings in the form of a payment increase determined according to a specified formula. Revises requirements for the composition of the expert outside advisory panel the Secretary is required to consult during the annual review of the clinical integrity of the groups and payment weights in the PPS for hospital OPD services. Requires the panel to include suppliers subject to the PPS as well as at least one ASC representative. Requires the Secretary, when excluding from a final rule updating ASC lists a procedure whose inclusion was requested during the public comment period, to cite in the final rule specific criteria based on which the procedure was excluded. Requires the Secretary also to identify the peer reviewed research or the evidence upon which the exclusion is based if certain of those criteria are cited for it. Prohibits the Secretary from using or citing as a criterion or a basis for an exclusion that the procedure can only be reported using a Current Procedural Terminology (CPT) unlisted surgical procedure code.