YourVoice.Now Summary
Your MoneyCorporate BenefitsStarting in 2026, Medicare would cap what you pay for surgery done at a surgery center.
Your Money
Today you pay 20 percent of what Medicare approves for the center's fee, with no cap. Under the bill, one procedure could not cost you more than the hospital deductible for that year.
Corporate Benefits
Surgery centers would not lose the money the cap takes off a patient's bill. Medicare would pay them an amount equal to the reduction.
More about this bill
If you have Medicare and get surgery at a surgery center, your share of the bill would get a ceiling. Medicare's rules now set your share at 20 percent of the approved amount, with no upper limit. Under this bill, your share for any one procedure could not top Medicare's hospital deductible for that year. That deductible is about $1,740 in 2026. Medicare would pay the surgery center the difference. The cap would apply to surgery done on or after January 1, 2026. It covers the center's own facility charge. Bills sent separately by the doctors involved are not part of the cap.
Congressional Summary
This bill limits the amount of coinsurance that may be assessed under Medicare for services performed in ambulatory surgical centers.Specifically, if the applicable coinsurance amount exceeds the inpatient hospital deductible, the Centers for Medicare & Medicaid Services must reduce the coinsurance amount so that it is equal to the amount of the deductible and pay the difference to the service provider.
Details
- Congress
- 119th
- Chamber
- House
- Status
- summarized
- Action
- Introduced in House
- Action Date
- 2025-04-24
- Date Added
- 2026-09-01
- Source
- Congress.gov →
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