Medicare Outpatient Surgery Savings, Access, and Quality Act of 1985

Summary

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.

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1 official file

• Introduced in Senate

  summary · EN · 24 July 1985

  Open at official source

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