U.S. Sen. Bill Cassidy (R-LA) on May 15 sponsored bipartisan legislation that would limit the coinsurance amount paid by Medicare patients for certain services furnished in an ambulatory surgical center (ASC).
“If your grandmother depended on Medicare for life-saving treatment, you would not want to hear that Medicare was cutting corners,” Sen. Cassidy said. “This bill makes costs fairer for patients while keeping the quality of care high.”
The senator introduced the Medicare Beneficiary Co-Pay Fairness Act of 2025, S. 1776, with lead cosponsor U.S. Sen. Richard Blumenthal (D-CT) to make Medicare’s copay structure more affordable.
If enacted, the legislation would extend the existing copay cap to ASCs to ensure fairer costs for patients, and to support the continued growth and utilization of efficient, lower-cost surgical settings, according to a bill summary provided by Sen. Cassidy’s staff.
Currently, while patients in both ASCs and hospital outpatient departments (HOPDs) typically face a 20-percent copay, only HOPDs benefit from a copay cap, which is set at $1,676 for 2025.
This leaves Medicare patients utilizing the more than 6,300 Medicare-certified ASCs nationwide with potentially higher out-of-pocket expenses for approximately 150 procedures, even though ASCs offer high-quality, cost-effective care projected to save Medicare billions, the summary says.
The bill has been referred to the U.S. Senate Finance Committee for consideration.