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Code · BILL · 116th Congress · S. 2102 (Introduced in Senate) — To provide funding for programs and activities under the SUPPORT for Patients and Communities Act. · Sec. 11

Sec. 11. Separate ambulatory payment classifications (APC) codes under the Medicare hospital outpatient department prospective payment system and the Medicare ambulatory surgical center payment system for surgeries utilizing non-opioid pain management drugs

297 words·~1 min read·/bill/116/s/2102/is/section-11

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Section 1833(t) of the Social Security Act ( 42 U.S.C. 1395l(t) ) is amended— in paragraph (2)(A), by striking the Secretary and inserting subject to paragraph (23), the Secretary ; and by adding at the end the following new paragraph: In the case of covered OPD services furnished on or after January 1, 2021, the classification system developed under paragraph (2)(A) shall provide for separate ambulatory payment classification codes for— surgeries that utilize non-opioid drugs, including such drugs delivered using an external infusion pump and the delivery mechanisms necessary for the delivery of such drugs, to treat pain after the surgery; and surgeries that utilize opioid drugs to treat pain after the surgery.
For purposes of this paragraph, the Secretary shall— treat any drug with a Food and Drug Administration indication for pain management during and after surgery that is also non-opioid as a non-opioid drug ; and establish a clear definition for non-opioid pain management drugs that do not have a Food and Drug Administration indication for pain management during or after the surgery. . Section 1833(i)(2)(D) of the Social Security Act ( 42 U.S.C. 1395l(i)(2)(D) ) is amended— by aligning the margins of clause
(v)with the margins of clause (iv); by redesignating clause
(vi)as clause (vii); and by inserting after clause
(v)the following new clause: In the case of surgical services furnished on or after January 1, 2021, the payment system described in clause
(i)shall provide for separate ambulatory payment classification codes for— consistent with subsection (t)(23), surgeries that utilize non-opioid drugs, including such drugs delivered using an external infusion pump and the delivery mechanisms necessary for the delivery of such drugs, to treat pain after the surgery; and surgeries that utilize opioid drugs to treat pain after the surgery. .
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Sec. 11
Separate ambulatory payment classifications (APC) codes under the Medicare hospital outpatient department prospective payment system and the Medicare ambulatory surgical center payment system for surgeries utilizing non-opioid pain management drugs
U.S.C.§ 1395l
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