S-1776 — Medicare Beneficiary Co-Pay Fairness Act

YourVoice.Now Summary

Your MoneyCorporate Benefits

Medicare's surgery-center facility fee would cost you no more than $1,736 in 2026 — today your 20% share has no ceiling.

Your Money

Your share of some surgery center bills — capped per procedure

Today a Medicare patient owes 20% of the center's Medicare rate with no limit, so a costly procedure can mean a very large bill. The bill would stop that share at the inpatient hospital deductible, $1,736 in 2026, for each surgical procedure.

Corporate Benefits

Surgery centers paid by Medicare instead of the patient

When the cap lowers what a patient owes, Medicare would pay the surgery center the difference. The center collects the same total as today, but more of it arrives straight from Medicare instead of from the patient.

More about this bill

If you have Medicare and need surgery at a surgery center, your bill could be smaller. Today you pay 20% of the Medicare rate for the center's own charge, with no ceiling. For a small share of procedures that comes to more than a hospital stay would cost you. Your share of the center's charge would stop at the inpatient hospital deductible. That is $1,736 in 2026. The bill does not set that amount itself; Medicare resets it every year. Hospital outpatient departments already have this cap, and surgery centers do not. Medicare would pay the center the difference, so the center loses nothing. The surgeon's own bill is separate and would not be capped. The bill applies to services on or after January 1, 2026, a date that has already passed while it sits in committee.

Congressional Summary

Medicare Beneficiary Co-Pay Fairness Act 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: Senate
Status: summarized
Action: Introduced in Senate
Action Date: 2025-05-15
Date Added: 2026-09-15
Source: Congress.gov →

Like reading a bill in plain English?

We're building an app that does this for every bill in Congress and lets you tell your reps how you want them to vote. We're a small team getting ready to launch, and we're trying to show investors that real people want this. Be one of them. Help us get it built. Leave your email and we'll tell you the moment the app is ready.