The legislative environment for ambulatory surgery centers (ASCs) shifted dramatically following the introduction of the *Outpatient Surgery Access Act of 2026* (H.R. 8091) by Representatives Beth Van Duyne (R-TX) and John Larson (D-CT). This critical bipartisan bill seeks to permanently align the ASC payment system with the same hospital market basket price index used for inpatient facilities, eliminating the outdated consumer price index adjustments that historically depressed surgery center payments. KNG Health Consulting projections indicate that stabilizing these reimbursement parameters will protect access to lower-cost care settings, with surgery centers forecasted to reduce overall Medicare program expenditure by $73.4 billion between 2019 and 2028. For multi-specialty facilities, the permanent resolution of this inflationary factor provides an essential buffer against skyrocketing clinical wages and malpractice premiums, establishing predictable revenue projections as the current five-year trial period expires at the end of December 2026.

The operational implications of H.R. 8091 are deeply tied to the elimination of the systemic secondary scaling calculations traditionally enforced by CMS. Historically, the agency scaled hospital outpatient department (HOPD) relative payment weights for budget neutrality and then applied an additional, ASC-specific weight scalar. This dual-tier compression artificially penalized surgery centers for the natural migration of case volumes to lower-cost settings. By mandating that CMS combine ASC and HOPD volume into a single outpatient weight scalar, the bill creates true budget neutrality while protecting baseline facility fees. For CY 2026, the current final rule applies a 2.6% payment update based on a 3.3% hospital market basket minus a 0.7% productivity adjustment, establishing a baseline conversion factor of $56.322. Without the structural interventions outlined in the new act, ASC updates would permanently revert to the Consumer Price Index for All Urban Consumers (CPI-U) in 2027, drastically flattening reimbursement growth curves relative to actual medical inflation.