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Medicare Beneficiary Co-Pay Fairness Act
To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.
Summary
This bill would amend Medicare law to cap coinsurance charges for certain surgical procedures performed in ambulatory surgical centers. When the coinsurance amount for facility services in an ambulatory surgical center would exceed the annual inpatient hospital deductible, the bill requires Medicare to reduce the coinsurance to equal that deductible amount and compensate the facility provider for the reduction. The provision would take effect for services furnished on or after January 1, 2026.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Sen. Cassidy, Bill [R-LA] (R-LA)
1 cosponsor
Money behind the sponsor
Top reported contributors to Bill Cassidy’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
- ANDREESSEN HOROWITZ $59,100
- GENERAL ATLANTIC $37,700
- WELSH CARSON ANDERSON & STOWE $33,870
- OCHSNER HEALTH SYSTEM $33,250
- RA CAPITAL MANAGEMENT $30,200
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Bill Cassidy → · Outside spending →
Actions (2)
- May 15, 2025 Read twice and referred to the Committee on Finance. · senate
- May 15, 2025 Introduced in Senate
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE SENATE OF THE UNITED STATES
May 15, 2025
Mr. Cassidy (for himself and Mr. Blumenthal) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Medicare Beneficiary Co-Pay Fairness Act”.
SEC. 2. LIMITATION ON COINSURANCE AMOUNT.
(a) In General.—Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended—
(1) in subsection (a)(1)(G), by inserting “subject to subsection (ee),” before “with respect to facility services”; and
(2) by adding at the end the following new subsection: “(ee) Limitation on Coinsurance Amount for Certain Services Furnished in an Ambulatory Surgical Center.—In the case that application of subsection (a)(1)(G) would result in the imposition of a coinsurance amount with respect to facility services described in such subsection furnished during a year with respect to a surgical procedure that exceeds the amount of the inpatient hospital deductible established under section 1813(b) for such year, the Secretary shall—
“(1) reduce the amount of such coinsurance to an amount equal to such deductible; and
“(2) pay to the supplier furnishing such services an amount equal to such reduction.”.
(b) Effective Date.—The amendments made by this section shall apply to services furnished on or after January 1, 2026. <all>
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