HR 3134, the Emergency Care Improvement Act, allows Medicare and Medicaid to reimburse freestanding emergency centers (FECs) for specific emergency services. The bill defines FECs as 24/7 facilities meeting state emergency care standards, with physician staffing, hospital referral agreements, and quality programs - currently operating in over 118 locations, primarily in Texas. It amends coverage rules to include FECs under Medicare Part B and Medicaid for "specified emergency services" (excluding certain evaluation codes), sets payment rates based on outpatient department standards, and extends EMTALA emergency care laws to cover these centers. This policy change directly affects FECs and Medicare/Medicaid beneficiaries by enabling reimbursement for emergency care previously excluded from coverage.
The PEAKS Act (HR 3778) modifies rules for critical access hospitals (CAHs) in mountainous or remote areas with limited road access. It changes ambulance service fee schedules to use a 15-mile drive limit (instead of 35 miles) in such locations, aligning with terrain challenges. The bill also allows CAHs that met the 15-mile distance requirement at their last certification to be deemed compliant through 2025, provided they have a new facility 10-15 miles away. These changes, effective January 1, 2026, aim to help CAHs maintain their status and funding eligibility. Regulations must be issued within one year of enactment.
This bill requires states to submit annual lists of individuals convicted of sexually violent offenses and deemed "sexually dangerous" under existing law to the Attorney General. The Attorney General must then review these lists to determine if federal prosecution is warranted. It also blocks Medicaid and Medicare funding for these individuals (unless receiving involuntary treatment in a hospital or nursing facility), directly affecting their access to healthcare coverage. The law targets a specific subset of offenders already classified under current federal standards, with no broader changes to sentencing or general sex offender registration.
HR 4250, the SOLES Act, adjusts Medicare payments for outpatient services at sole community hospitals located only in Alaska or Hawaii. If a hospital’s Medicare payment for outpatient services is less than 94% of its reasonable costs, the bill requires the government to increase the payment to cover the shortfall. The bill explicitly states this adjustment won’t affect patient copayments or count toward budget neutrality requirements. Regulations implementing the changes must be finalized within six months of the bill’s enactment.
HR 3443 creates a new Medicare payment model to provide supplemental funding for ground and air ambulance services that administer specific life-saving medications (like epinephrine, lidocaine, and blood products) during emergencies. It directly affects EMS agencies serving Medicare beneficiaries by requiring them to apply for participation, meet data reporting standards (including patient outcomes and service metrics), and receive monthly or quarterly supplemental payments based on costs for maintaining medication supplies and data systems. The model runs for at least 5 years, with a requirement for a congressional report analyzing whether the payments improve medication access, patient outcomes, and care quality - especially for rural and underserved communities. The bill also mandates a MedPAC report on EMS payment structures and EMTALA guidance to reduce "wall time" delays in hospital handoffs.
This bill requires every Department of Veterans Affairs (VA) hospital and urgent care facility to employ at least one Sexual Assault Nurse Examiner (SANE) or a qualified healthcare provider to perform sexual assault forensic examinations. It mandates that after such an examination, veterans must be verbally referred to mental health services, either at the VA hospital or via a Veterans Care Agreement if VA wait times exceed 30 days. The bill explicitly prohibits any reduction in other patient care responsibilities for VA staff while implementing these requirements. The law directly affects veterans seeking sexual assault care at VA facilities by ensuring access to specialized examiners and timely mental health referrals.
This bill extends the temporary waiver allowing hospitals to provide acute care at home until 2030, directly affecting hospitals participating in the Acute Hospital Care at Home initiative and the patients receiving care through this program. It requires the Department of Health and Human Services to conduct a detailed study by September 2028, comparing care quality, costs, patient outcomes, and experiences between home-based care and traditional inpatient hospital care. The study must analyze specific metrics like readmission rates, staffing ratios, treatment types, and patient demographics across participating and non-participating hospitals. The findings will be reported to Congress, providing data to inform future policy decisions about home-based hospital care.
HR 2793, the Retirement Freedom Act, allows Medicare Part A beneficiaries to voluntarily opt out of the program. Individuals who choose to opt out can later rejoin Medicare Part A without penalty or additional requirements, and they will not be required to give up Social Security benefits (Title II) to make this choice. The bill also ensures beneficiaries won't have to repay Medicare Part A payments received before opting out. This change directly affects current Medicare Part A enrollees who wish to explore alternative health coverage options.
The Keeping Obstetrics Local Act aims to improve access to maternity care, particularly in rural and underserved communities, by requiring states to study the costs of obstetric services and ensuring hospitals receive adequate Medicaid payments. It establishes "anchor payments" for low-volume obstetric hospitals to prevent closures, mandates 12-month continuous coverage for pregnant individuals under Medicaid and CHIP, and creates health homes for coordinated maternal care. The bill also requires hospitals to notify communities 180 days before closing obstetric units and collect detailed data on labor and delivery services. This legislation directly affects rural and safety net hospitals, pregnant individuals, and maternal health providers across the country.
HR 609, the Assuring Medicare's Promise Act of 2025, directs revenue from the net investment income tax (currently applied to investment income) into the Medicare Hospital Insurance Trust Fund. It expands the tax base to include certain business income for high-income individuals with modified adjusted gross income exceeding $400,000 ($500,000 for joint filers), with a phase-in to limit the tax increase. The bill ensures this tax revenue directly supports Medicare's hospital insurance program, applying to taxable years beginning after December 31, 2025. The changes do not alter the tax rate but broaden the income types subject to the tax for high earners.
