Medicare Beneficiary Co-Pay Fairness Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1776 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 1776

     To amend title XVIII of the Social Security Act to limit the 
  coinsurance amount for certain services furnished in an ambulatory 
                            surgical center.


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                   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

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                                 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.
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