HR 5395 United States House · 118th Congress

Coverage Parity for Medicare Patients Act of 2023

This bill creates a Medicare demonstration program to align coverage standards with private insurance. It would deem certain medical services "reasonable and necessary" for Medicare coverage if they are routinely covered by a majority of private health plans in the same state or Medicare contractor area, are safe/effective, and aren't experimental (unless in a qualifying clinical trial). The program would operate for at least 4 years in 5+ states or jurisdictions, with the Secretary establishing rules for what constitutes "significant coverage" through rulemaking. It directly affects Medicare beneficiaries in participating areas and healthcare providers billing Medicare for covered services meeting these criteria. The bill does not change current Medicare coverage rules but tests a new alignment mechanism.
Sub-Topics: Medicare Telehealth
Bill status in committee 1 of 4 stages cleared
Introduction
Sep 2023
Committee Review
Floor Vote
President
Introduced Sep 12, 2023 Last action Dec 17, 2024
Floor votes

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Full legislative history

Actions timeline

Total actions
4
Key actions
0
Committee
3
Dec 17, 2024
Committee
Referred to the Subcommittee on Health.
lower
Sep 15, 2023
Committee
Referred to the Subcommittee on Health.
lower
Sep 12, 2023
Committee
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
lower
Sep 12, 2023
Introduced
Introduced in House
lower
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of Diana Harshbarger
Diana Harshbarger
RRepublican
TN
1