Healthcare (Medicare)

in committee · United States · House Dec 16, 2025

HR 6743: Medicare Investment and Gun Violence Prevention Act

This bill reinstates $200 transfer and manufacturing taxes on most firearms (replacing reduced rates from prior law) and maintains a $5 tax for "other weapons," effective 90 days after enactment. It also adds $1.7 billion to the Medicare Part A trust fund for fiscal year 2026, specifically for hospital insurance. The provisions directly affect firearm sellers/manufacturers through tax changes and Medicare beneficiaries through increased trust fund funding. These are concrete financial adjustments with no new regulatory requirements or eligibility changes. The bill focuses on restoring prior tax rates and providing dedicated Medicare funding, without altering benefit structures.

Topics ✓ Budget & TaxesSupports Budget & TaxesAdds $1.7B to Medicare Part A trust fund for hospital insurance, funding essential public service.90% confidence ✓ HealthcareSupports HealthcareAdds $1.7B to Medicare Part A trust fund for hospital insurance, directly increasing healthcare program funding.95% confidence

Sub-Topics Hospitals Medicare

Track

in committee · United States · Senate Mar 27, 2025

S 1168: Portable Ultrasound Reimbursement Equity Act of 2025

This bill, S 1168 (Portable Ultrasound Reimbursement Equity Act of 2025), would expand Medicare coverage to include separate reimbursement for portable ultrasound transportation and setup services, mirroring the existing payment structure for portable X-ray services. It directly affects medical equipment suppliers who provide mobile ultrasound services to Medicare beneficiaries. The bill amends Medicare law to require the Secretary to establish payment rules for portable ultrasound services that are substantially similar to those for portable X-ray services under existing regulations. These changes would take effect for services furnished on or after January 1, 2027.

Topics ✓ HealthcareSupports HealthcareExpands Medicare reimbursement for portable ultrasound services, improving access to mobile medical equipment for beneficiaries by mirroring existing portable X-ray payment structure.95% confidence

Sub-Topics Medicaid Medicare Telehealth

Track

in committee · United States · House Jan 31, 2025

HR 870: Physicians for Underserved Areas Act

HR 870, the Physicians for Underserved Areas Act, amends Medicare rules to improve how residency slots are redistributed when hospitals close. It requires hospitals to ensure that redistributed residency positions are filled within five years (previously only a vague "likelihood" standard existed). This change directly affects hospitals participating in Medicare that close and the residency programs receiving the reassignable slots. The policy focuses on ensuring residency positions are actually filled after closures, rather than just being available.

Topics ✓ HealthcareSupports HealthcareRequires hospitals to fill redistributed residency slots within 5 years, maintaining physician workforce continuity in underserved areas and improving healthcare access.95% confidence

Sub-Topics Hospitals Medicaid Medicare

Track

in committee · United States · House Sep 8, 2025

HR 5198: Rural Health Clinic Location Modernization Act of 2025

HR 5198, the Rural Health Clinic Location Modernization Act of 2025, changes Medicare eligibility rules for rural health clinics by updating the definition of "urban area" used to determine clinic qualification. It replaces the current "urbanized area" standard with a clearer definition: any urban area (per Census Bureau data) having a population of 50,000 or more. This adjustment directly affects clinics seeking Medicare certification, ensuring they meet consistent geographic criteria for rural designation. The change takes effect January 1, 2027, aiming to simplify qualification rules without altering Medicare coverage or benefits.

Topics ✓ HealthcareSupports HealthcareUpdates Medicare eligibility to expand rural clinic access to Medicare certification, improving healthcare access in underserved areas by clarifying geographic criteria.92% confidence

Sub-Topics Medicare Primary Care Tags Rural Communities

Track

in committee · United States · House Dec 5, 2025

HR 6494: Territories Health Equity Act of 2025

Territories Health Equity Act of 2025 This bill alters provisions relating to the treatment of U.S. territories under Medicaid, Medicare, and Medicare Advantage. For example, the bill eliminates Medicaid funding limitations for U.S. territories beginning in FY2026, exempts an individual from late-enrollment penalties for Medicare medical services if the individual resided in Puerto Rico as of the date of eligibility and the individual enrolls within five years of such date, and establishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within U.S. territories. The bill also allows residents of U.S. territories who are unable to obtain health insurance through their employer or a health insurance exchange to instead obtain coverage that is at least as broad as the coverage available to Members of Congress and their staff through the District of Columbia exchange.

Topics ✓ HealthcareSupports HealthcareEliminates Medicaid funding limits for territories and exempts Puerto Rico residents from Medicare late penalties, expanding healthcare access and coverage.95% confidence

Sub-Topics Insurance Medicaid Medicare

Track

in committee · United States · House Dec 11, 2025

HR 6609: Pharmacists Fight Back in Medicare and Medicaid Act

This bill establishes new requirements for pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans and Medicaid programs. It mandates that PBMs pay pharmacies a specific reimbursement amount based on drug acquisition costs plus a fixed fee, pass through manufacturer rebates directly to beneficiaries at the point of sale, and prohibits steering practices that direct patients to specific pharmacies. The bill applies to Medicare Part D plans and Medicaid managed care organizations beginning January 1, 2027, affecting how PBMs interact with pharmacies and handle drug rebates. Violations could result in criminal penalties of up to $1 million or 10 years in prison for willful noncompliance. The bill aims to increase transparency and fairness in pharmacy drug pricing for Medicare and Medicaid beneficiaries.

Topics ✓ HealthcareSupports HealthcareMandates fair PBM reimbursement, direct rebate passes to beneficiaries, prohibits steering - strengthens patient access and pharmacy payments in Medicare/Medicaid programs.85% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

Track

in committee · United States · House Jan 30, 2026

HR 7277: Emergency Medical Services Reimbursement for On-Scene and Support Act

HR 7277, the Emergency Medical Services Reimbursement for On-Scene and Support Act, expands Medicare reimbursement to ambulance providers for non-transport emergency medical services. It amends the Social Security Act to allow reimbursement for on-scene care (like medical treatment at the location) provided on or after January 1, 2026, regardless of whether transport was offered. This directly affects ambulance service providers who currently may not receive payment for non-transport care. The bill requires reimbursement for these on-scene services to be comparable to transport reimbursement rates, ensuring consistent payment for similar care. The policy change takes effect in 2026, addressing a gap in coverage for emergency care delivered without patient transport.

Topics ✓ HealthcareSupports HealthcareExpands Medicare reimbursement for on-scene EMS care, improving access to emergency services and funding providers currently excluded from payment for non-transport care.95% confidence

Sub-Topics Medicare

Track

in committee · United States · House Oct 3, 2025

HR 842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act

This bill adds Medicare coverage for multi-cancer early detection screening tests (blood or biological tests analyzing cell-free DNA) starting January 1, 2028. It directly affects Medicare beneficiaries aged 68 and older (starting in 2028, with the age limit increasing by 1 year annually), requiring tests to be FDA-cleared and deemed reasonable/necessary by the Secretary for early cancer detection across multiple organ sites. Payment will initially match current stool DNA test rates before 2031, then shift to a lower rate or new payment system after 2031, with limits preventing more than one test per year. The bill explicitly states it does not alter coverage for existing cancer screenings like breast, colorectal, or prostate cancer tests.

Topics ✓ HealthcareSupports HealthcareAdds Medicare coverage for multi-cancer screening tests, expanding access for beneficiaries aged 68+ starting 2028.95% confidence

Sub-Topics Medicaid Medicare

Track

in committee · United States · Senate Feb 24, 2025

S 694: PLASMA Act

The PLASMA Act (S 694) modifies Medicare Part D drug discount rules for plasma-derived products - biological drugs made from human blood plasma. It establishes a phased reduction in the discount rate these drugs must offer to Medicare beneficiaries, starting at 99% of the negotiated price in 2026 and gradually decreasing to 80% by 2032. This affects manufacturers of plasma-derived drugs covered under Medicare Part D and beneficiaries who meet specific out-of-pocket cost thresholds. The bill excludes certain low-income beneficiaries and small manufacturers from these provisions. The policy change directly alters how drug costs are calculated for these specific medications under Medicare.

Topics ✗ HealthcareOpposes HealthcareBill reduces Medicare Part D discounts for plasma drugs from 99% to 80% by 2032, increasing beneficiary out-of-pocket costs and restricting access to affordable treatments.85% confidence

Sub-Topics Medicare Prescription Drugs

Track

in committee · United States · House Aug 22, 2025

HR 5031: Preserving Patient Access to Long-Term Care Pharmacies Act

HR 5031, the *Preserving Patient Access to Long-Term Care Pharmacies Act*, requires Medicare Part D plans and Medicare Advantage plans with drug coverage (MA-PD) to pay long-term care pharmacies an additional supply fee for each specified prescription dispensed to eligible beneficiaries during 2026 ($30) and 2027 (adjusted for inflation). This fee must be paid alongside existing reimbursements for drug costs and dispensing, with a $10,000 penalty for non-payment. The bill also directs the GAO to study long-term care pharmacy payment sustainability under Medicare, analyzing historical payments for brand/generic drugs and dispensing fees. It aims to ensure uninterrupted pharmacy access for Medicare beneficiaries in long-term care settings, particularly in rural areas.

Topics ✓ HealthcareSupports HealthcareMandates additional payments to long-term care pharmacies to ensure continued access to medications for Medicare beneficiaries, directly improving patient access to essential pharmacy services.95% confidence

Sub-Topics Long-Term Care Medicare Prescription Drugs

Track