Healthcare (Medicare)

in committee · United States · House Aug 12, 2025

HR 4960: BENES 2.0 Act

HR 4960 (BENES 2.0 Act) requires Social Security to include clear Medicare eligibility information in annual statements mailed to individuals reaching ages 60-65. The notice must explain enrollment rules, late penalties, relief options, and special considerations for veterans and Puerto Rico residents, with practical examples. Statements will be mailed 6 months before age 65 and updated every 2 years based on stakeholder feedback. This directly affects all Americans approaching Medicare eligibility through Social Security.

Topics ✓ HealthcareSupports HealthcareRequires clear Medicare enrollment info to improve access and reduce penalties for beneficiaries, aligning with patient access indicators.90% confidence

Sub-Topics Medicare

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in committee · United States · House Jul 7, 2025

HR 4299: Protecting Patient Access to Cancer and Complex Therapies Act

This bill requires drug manufacturers to pay rebates to Medicare when their "selected drugs" (cancer and complex therapies subject to negotiated maximum fair prices) are used. Manufacturers must calculate rebates based on the difference between current Medicare payment rates (ASP+6) and new negotiated rates (MFP+6), covering the gap for beneficiaries. This lowers patient coinsurance from the current 20% of ASP+6 to 20% of MFP+6 for these specific drugs during the negotiated price period. The rebates are paid to the Medicare trust fund and apply to Medicare Part B beneficiaries using these drugs, directly affecting drug manufacturers and patients covered under Medicare Part B.

Topics ✓ HealthcareSupports HealthcareLowers patient coinsurance for cancer drugs by requiring manufacturer rebates, directly improving access to high-cost therapies under Medicare.95% confidence

Sub-Topics Medicare Prescription Drugs

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in committee · United States · House Feb 13, 2025

HR 1317: I CAN Act

Improving Care and Access to Nurses Act or the I CAN Act This bill allows other health care providers besides physicians (e.g., nurses) to provide certain services under Medicare and Medicaid. Among other changes, the bill (1) allows a nurse practitioner or physician assistant to fulfill documentation requirements for Medicare coverage of special shoes for diabetic individuals; (2) expedites the ability of physician assistants, nurse practitioners, and clinical nurse specialists to supervise Medicare cardiac, intensive cardiac, and pulmonary rehabilitation programs; and (3) allows nurse practitioners to certify the need for inpatient hospital services under Medicare and Medicaid.

Topics ✓ HealthcareSupports HealthcareBill expands Medicare/Medicaid coverage for nurse practitioners and PAs to provide services (e.g., diabetic shoe documentation), improving patient access to care without physician oversight.95% confidence

Sub-Topics Healthcare Workforce Hospitals Medicare

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in committee · United States · House Sep 26, 2025

HR 5592: Childhood Genital Mutilation Prevention Act

HR 5592, the Childhood Genital Mutilation Prevention Act, prohibits medical procedures related to gender identity for minors under 18, with exceptions for treating specific medical conditions like disorders of sex development or injuries. It criminalizes performing such treatments under certain circumstances (e.g., involving interstate commerce) with penalties up to 10 years in prison, while exempting care for diagnosed medical needs. The bill also excludes these procedures from Medicare/Medicaid coverage after 90 days and bans federal funding for such treatments or related health coverage. This directly affects minors under 18, healthcare providers, and insurers offering these services, but allows exceptions for medically necessary care.

Topics ✗ Criminal JusticeOpposes Criminal JusticeCriminalizes medical procedures for minors with prison penalties, expanding criminalization per indicators.85% confidence ✗ HealthcareOpposes HealthcareRestricts gender-affirming medical care for minors under 18, criminalizing procedures except for diagnosed medical conditions, limiting access to healthcare services.95% confidence

Sub-Topics Corrections Medicaid Medicare

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in committee · United States · House Sep 16, 2026

HR 5439: Medically Tailored Home-Delivered Meals Program Pilot Act

This bill creates a 6-year Medicare pilot program providing medically tailored home-delivered meals and nutrition counseling to specific high-risk Medicare patients after hospital discharge. It targets individuals with diet-impacted conditions (like diabetes or heart failure) who live at home, have limited mobility, and are at high risk of hospital readmission. Selected hospitals must meet quality standards, screen patients using approved tools, and deliver at least two meals daily meeting nutritional needs while respecting cultural/religious dietary requirements, all without patient cost-sharing. The program requires hospitals to submit data for the Secretary to evaluate health outcomes, readmission rates, and cost savings compared to non-participants. Funding comes from the Medicare Hospital Insurance Trust Fund, offset by reductions to other hospital payments to maintain budget neutrality.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill creates federal funding for Medicare pilot program targeting high-risk patients, advancing essential healthcare spending through government appropriation.95% confidence ✓ HealthcareSupports HealthcareCreates Medicare-funded pilot for medically tailored meals to reduce readmissions, expanding coverage for diet-impacted conditions like diabetes.95% confidence

Sub-Topics Government Spending Hospitals Medicare

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in committee · United States · House Jun 20, 2025

HR 4056: RAMP Act

Repair Abuses of MSP Payments Act or the RAMP Act This bill restricts the private right of action against insurance plans that do not provide appropriate primary payment in cases in which Medicare is a secondary payer. Current law allows for a private right of action against primary plans that do not provide appropriate primary payment in cases in which Medicare is a secondary payer; this provision applies to group health plans, workers' compensation plans, automobile or liability insurance plans, and no-fault insurance plans. The bill limits this provision to group health plans.

Topics ✗ HealthcareOpposes HealthcareBill restricts private lawsuits against insurers for Medicare secondary payer payment errors, reducing patient access to compensation for coverage disputes in healthcare insurance.90% confidence

Sub-Topics Medicare

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in committee · United States · House Dec 18, 2025

HR 6894: Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025

This bill expands Medicare coverage for cardiac and pulmonary rehabilitation programs by allowing more healthcare providers to prescribe these services. It specifically permits physician assistants, nurse practitioners, and clinical nurse specialists (in addition to physicians) to prescribe rehabilitation exercises under Medicare. The bill modifies existing Medicare definitions to include these providers, removing the exclusive reference to "physicians" in program requirements. These changes apply to both cardiac and pulmonary rehabilitation programs and take effect six months after the bill becomes law. The policy directly affects Medicare beneficiaries seeking these rehabilitation services and healthcare facilities providing them.

Topics ✓ HealthcareSupports HealthcareExpands Medicare coverage for cardiac rehab by allowing non-physician providers to prescribe, improving patient access to care under existing Medicare framework.95% confidence

Sub-Topics Healthcare Workforce Medicare

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in committee · United States · House Sep 8, 2025

HR 5178: Sickle Cell Disease Comprehensive Care Act

Sickle Cell Disease Comprehensive Care Act This bill allows state Medicaid programs to establish health homes to provide coordinated care for individuals with sickle-cell disease. (Under current law, state Medicaid programs may establish health homes to provide coordinated care for individuals with specified chronic conditions.) States must ensure that such care includes dental and vision services. The Centers for Medicare & Medicaid Services must issue best practices for states on how to design and implement such health homes.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid health homes for sickle-cell disease, mandates dental/vision services, and requires CMS best practices - enhancing coordinated care access and coverage.95% confidence

Sub-Topics Medicaid Medicare

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in committee · United States · House Oct 17, 2025

HR 5768: Skin Substitute Access and Payment Reform Act

This bill ensures Medicare covers and pays for skin substitute products (used in wound care) by creating a new payment system starting in 2026. It establishes a payment rate based on a volume-weighted average of past payment data, adjusted annually for inflation, and requires a new billing code for these products by January 2026. The bill also adds program integrity measures: identifying the top 3% of providers by payment volume (outliers) for extra review, and requiring prior authorization for their claims starting in 2027. Additionally, it mandates coverage for these products in 2026 unless unsafe, and prohibits denying coverage solely based on clinical evidence analysis.

Topics ✓ HealthcareSupports HealthcareBill ensures Medicare coverage for skin substitute products, creating a new payment system to expand access to wound care services. Directly advances patient access to specialized healthcare products.90% confidence

Sub-Topics Medicare

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in committee · United States · House Mar 27, 2025

HR 2477: Portable Ultrasound Reimbursement Equity Act of 2025

HR 2477, the Portable Ultrasound Reimbursement Equity Act of 2025, would amend Medicare rules to require equal reimbursement for portable ultrasound transportation and setup services as is currently provided for portable X-ray services. This change directly affects Medicare beneficiaries needing portable ultrasound exams and healthcare providers (like mobile clinics) who offer these services. The bill mandates that Medicare pay separately for portable ultrasound transportation and setup in the same way and to the same extent as portable X-ray services, using similar supplier requirements as existing regulations. The policy change would take effect for services provided on or after January 1, 2027.

Topics ✓ HealthcareSupports HealthcareBill mandates equal Medicare reimbursement for portable ultrasound services, improving access for beneficiaries and providers by correcting a disparity in coverage for similar medical services.95% confidence

Sub-Topics Medicaid Medicare Telehealth

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