Issues & Advocacy

ASCA’s National Advocacy Day is your opportunity to make a direct impact on policies affecting ambulatory surgery centers (ASCs) nationwide. Through face-to-face meetings with lawmakers and their staff, we advocate for key legislative and regulatory issues that support patient access, ASC growth, and high-quality surgical care. Stay informed on the latest policy priorities and join us in advancing the future of outpatient surgery.

Eliminate the Copay Penalty for Medicare Part B Services

Issue:

A beneficiary typically has a coinsurance responsibility of 20 percent of the procedure’s cost when that procedure is performed in an ASC. When a beneficiary receives the same procedure in an HOPD, the copay is capped at the inpatient deductible amount, which is $1,676 for 2025, and the hospital is made whole by the Medicare program. This copay penalty limits patients’ access to care in ASCs and ultimately increases costs to Medicare, its beneficiaries and taxpayers.

This issue primarily impacts those without supplemental coverage—an area where a racial disparity in access has been observed, with only 40 percent of black beneficiaries being covered by supplemental insurance in contrast to 72 percent of white beneficiaries.

Solution:

We propose that the same framework that applies to HOPD services should apply to ASCs, capping a beneficiary’s copay and making the facility whole for the difference.

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