This bill extends the deadline for certain veterans' dependents to file claims for medical care under the CHAMPVA program. It applies to individuals already eligible for CHAMPVA benefits who also have Medicare Part A hospital coverage. The key change ensures that after receiving official approval for retroactive care, these individuals have a full 365 days (not earlier than one year) to file their claim. The extension applies from the bill's enactment date until September 30, 2027.
The Telehealth Coverage Act of 2025 makes permanent Medicare telehealth flexibilities that were temporarily expanded during the pandemic. It eliminates in-person visit requirements for mental health services, substance use disorder treatment, home dialysis visits, and stroke care, allowing these to be provided via telehealth. The bill also expands who can provide telehealth services, extends coverage for rural health clinics and community health centers, and requires new billing modifiers for certain telehealth claims by January 2026. Additionally, it includes guidance to help providers serve patients with limited English proficiency through telehealth and expands access to virtual diabetes prevention programs. These changes primarily affect Medicare beneficiaries, healthcare providers, and telehealth technology companies.
Improving Access to Medicare Coverage Act of 2025 This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility (SNF) services. (Generally, individuals must have been an inpatient at a hospital for at least three days in order to qualify for SNF services. An individual's time spent under observation at a hospital for purposes of determining whether the individual should be admitted does not count towards this requirement.)
The SEPSIS Act (HR 7116) establishes a dedicated sepsis program within the CDC to improve national sepsis response. It requires the CDC Director to lead education campaigns on hospital sepsis best practices, enhance pediatric sepsis data collection, and coordinate with Medicare/Medicaid to develop quality measures. Hospitals would be asked to report on sepsis protocol adoption, with a voluntary "honor roll" recognizing top performers in early detection and treatment. The bill authorizes $20 million annually (2026-2030) for these efforts and mandates annual congressional briefings on sepsis data and hospital progress. This directly affects hospitals, CDC operations, and federal health agencies working to reduce sepsis-related deaths and costs.
This bill amends the Federal Trade Commission Act to expand the FTC's authority over certain tax-exempt hospitals. It adds "any hospital organization or cooperative hospital service organization described in section 501(c)(3) of the Internal Revenue Code" to the definition of "corporation" under FTC jurisdiction. This change directly affects tax-exempt hospitals and hospital cooperatives that qualify under 501(c)(3), allowing the FTC to investigate and act against their anti-competitive practices. The key mechanism is simply updating the legal definition to include these specific healthcare entities under existing FTC oversight.
The 340B ACCESS Act strengthens oversight of the 340B Drug Pricing Program, which allows safety-net hospitals and clinics to purchase outpatient drugs at discounted prices. The bill clarifies who qualifies as a "patient" for 340B discounts, establishes new requirements for hospital child sites and contract pharmacies, and mandates that covered entities implement sliding fee scales to ensure patient affordability based on income. It creates a claims data clearinghouse to prevent duplicate Medicaid discounts and requires covered entities to report detailed data about drug dispensing. These changes aim to ensure 340B discounts reach intended patients while preventing program misuse and ensuring transparency.
The Ensuring Access to General Surgery Act of 2026 directs the Health Resources and Services Administration to study how to better identify areas with insufficient general surgeons, particularly in rural and underserved communities. The study will evaluate current shortage designations and test a new methodology using hospital service areas and surgeon-to-population ratios to set accurate thresholds for shortage levels (e.g., critical shortage, adequate supply). Within one year, the Secretary must submit a report to Congress and publish data on surgeon availability, with annual updates to any designated shortage areas. This process aims to improve the accuracy of shortage identification to inform future resource allocation for surgical care access.
This bill creates a pathway for Medicare to cover innovative medical devices earlier. It allows "breakthrough devices" (new technologies designated for expedited FDA review) to qualify for Medicare's "new technology add-on payment" if approved, cleared, or authorized by the FDA before July 1 of a fiscal year. This means Medicare beneficiaries gain faster access to these new devices, and hospitals receive additional payment for using them, effective in the first quarter after FDA approval. The provision applies to devices approved on or after July 1, 2023, and is designed to be budget-neutral.
Patient Access to Higher Quality Health Care Act of 2025 This bill repeals provisions under the Stark law (i.e., the Physician Self-Referral Law) that limit, for purposes of Medicare participation, self-referrals by newly constructed or expanded physician-owned hospitals.
This bill establishes minimum nurse-to-patient ratios for hospital units across the country, requiring hospitals to maintain specific staffing levels (such as 1:1 in trauma units, 2:1 in critical care units, and 3:1 in emergency rooms) to improve patient safety and quality of care. Hospitals must develop transparent staffing plans that account for patient acuity, involve direct care nurses in planning, and document actual staffing levels for each shift. The bill includes strong whistleblower protections for nurses who object to unsafe staffing levels and prohibits hospitals from retaliating against nurses who report violations. It requires hospitals to comply with these standards as a condition for receiving Medicare and Medicaid payments, with enforcement through audits and civil penalties of up to $50,000 for repeated violations. The bill also includes provisions to support nurse recruitment and retention through workforce initiatives and training programs.
