A bill to amend title XVIII of the Social Security Act with respect to the payment amount for ambulatory surgical procedures, and for other purposes.
Medicare Outpatient Surgery Savings, Access, and Quality Act of 1985 - Amends title XVIII (Medicare) of the Social Security Act to prohibit the standard overhead amount established for a surgical procedure performed either in an ambulatory surgical center (ASC) or in a physician's office from exceeding the DRG rate for the same surgical procedure when provided to a hospital inpatient. Provides that the amount of the charge that will be considered reasonable for facility services: (1) for a surgical procedure which can be performed on an inpatient basis and in an ASC but which is provided on an outpatient basis in a hospital shall be equal to the standard overhead amount for the same procedure provided in an ASC; and (2) for a surgical procedure provided on an outpatient basis in a hospital shall not exceed the DRG rate for the same procedure when provided on an inpatient basis in a hospital in the same area.
Requires a utilization and quality control peer review organization to review all ambulatory surgical procedures which can also be performed on a hospital inpatient basis.
Prohibits imposing licensing requirements on an ASC that are not imposed on similar entities.
Requires copayments for procedures performed in an ASC.
Introduced in Senate
Read twice and referred to the Committee on Finance.
Committee on Finance requested executive comment from OMB, Treasury Department, Health and Human Services Department.
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