Medicare Beneficiary Co-Pay Fairness Act

The Medicare Beneficiary Co-Pay Fairness Act (S 1776) limits out-of-pocket costs for Medicare beneficiaries receiving certain surgical procedures at ambulatory surgical centers. It ensures that coinsurance payments for these services cannot exceed the annual inpatient hospital deductible amount for the same year. If the standard coinsurance would surpass that deductible, the bill requires the Medicare Secretary to cap the beneficiary's payment at the deductible level and reimburse the surgical center for the difference. This change applies to services provided on or after January 1, 2026, directly affecting Medicare beneficiaries undergoing qualifying surgeries.