Healthcare (Medicare)

in committee · United States · House Jun 5, 2025

HR 3789: DTC Act of 2025

The DTC Act of 2025 requires pharmaceutical companies to include a drug's list price (for a 30-day supply) in direct-to-consumer television and digital ads for prescription drugs covered by Medicare or Medicaid. It applies to ads for drugs costing $35 or more per 30-day supply, exempting lower-cost medications. Manufacturers must disclose the list price clearly by July 1, 2026, with penalties of up to $100,000 per violation for noncompliance. The bill aims to provide consumers with upfront pricing information to help them compare costs before filling prescriptions, particularly affecting drugs commonly advertised to Medicare beneficiaries.

Topics ✓ HealthcareSupports HealthcareRequires transparent drug pricing in ads for Medicare/Medicaid drugs, empowering consumers to make informed healthcare cost decisions.90% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

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in committee · United States · Senate Jul 17, 2025

S 2329: Medicare Orthotics and Prosthetics Patient-Centered Care Act

This bill prohibits Medicare from paying for orthotics and prosthetics delivered via "drop shipment" (direct shipping to patients without proper training from a qualified provider) starting after its enactment. It expands the list of healthcare professionals who can order these devices to include physical therapists, occupational therapists, orthotists, and prosthetists. The bill also ensures Medicare beneficiaries can get covered replacements for custom-fitted orthotics and custom-fabricated orthotic devices. These changes aim to improve patient safety and access to appropriate care by requiring in-person training and clarifying coverage rules. The Secretary of Health and Human Services must issue implementing regulations within one year of the bill's enactment.

Topics ✓ HealthcareSupports HealthcareExpands provider eligibility for orthotics/prosthetics orders and ensures covered replacements, improving Medicare patient access and safety standards.95% confidence

Sub-Topics Medicare

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in committee · United States · House Dec 18, 2025

HR 6841: PEERS Act of 2025

The PEERS Act of 2025 requires Medicare to cover peer support services provided by certified specialists at community mental health centers, rural health clinics, and other specified facilities. It directly affects Medicare beneficiaries with mental health or substance use disorders who receive these services, and providers like community mental health centers that will now bill Medicare for this care. The bill defines peer support services as non-clinical assistance focused on recovery, community integration, and self-empowerment, delivered by individuals certified after recovering from similar conditions. Coverage begins January 1, 2027.

Topics ✓ HealthcareSupports HealthcareBill mandates Medicare coverage for peer support services in mental health/substance use treatment, expanding access and funding for these critical services under healthcare policy.95% confidence

Sub-Topics Medicare Mental Health Substance Abuse

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in committee · United States · House Jun 26, 2025

HR 4185: Integrating Social Workers Across Health Care Settings Act

This bill amends the Social Security Act to expand Medicare coverage for clinical social worker services. It removes the current restriction limiting these services to "the diagnosis and treatment of mental illnesses," allowing Medicare to cover a broader range of social worker services in healthcare settings. The change applies to services provided on or after December 1, 2025, directly affecting Medicare beneficiaries who receive social work services for non-mental health conditions. This policy adjustment aims to integrate social workers more fully into general healthcare coverage under Medicare.

Topics ✓ HealthcareSupports HealthcareExpands Medicare coverage for social workers beyond mental health to include broader healthcare services, directly advancing patient access and coverage under Medicare.95% confidence

Sub-Topics Medicare Mental Health

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in committee · United States · House Jun 26, 2025

HR 4206: CONNECT for Health Act of 2025

The CONNECT for Health Act of 2025 expands Medicare telehealth coverage by removing geographic restrictions that limited where patients could receive care, expanding the types of health care providers who can offer telehealth services, and eliminating the requirement for an in-person visit before receiving telemental health services. The bill includes specific provisions to support telehealth use for Native American health facilities, rural health clinics, and Federally Qualified Health Centers. It requires the Centers for Medicare & Medicaid Services to collect and publish data on telehealth usage and impacts, and to develop resources to improve accessibility for people with disabilities and limited English proficiency. Program integrity measures are added to monitor telehealth billing practices and prevent fraud while maintaining coverage for telehealth services during public health emergencies.

Topics ✓ HealthcareSupports HealthcareExpands Medicare telehealth coverage by removing geographic restrictions, allowing more providers, and eliminating pre-visit requirements for telemental health, improving access for rural and underserved communities.95% confidence ✓ TechnologySupports TechnologyExpands telehealth access by removing geographic restrictions and supporting rural/underserved areas, advancing technology-enabled healthcare delivery.90% confidence

Sub-Topics Medicaid Medicare Telehealth

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in committee · United States · Senate Nov 19, 2025

S 3221: Expanding Health Care Options for First Responders Act

Senate Bill 3221, the Expanding Health Care Options for First Responders Act, creates a Medicare buy-in program for retired or disabled first responders aged 50 to 64. Eligible individuals - including law enforcement officers, certain public safety employees, and federal firefighters - can enroll in Medicare Parts A, B, and D at a premium calculated based on average Medicare costs for this group. The coverage counts as "minimum essential coverage" under the Affordable Care Act, making enrollees eligible for premium tax credits and cost-sharing subsidies. The bill also establishes an oversight board and provides federal grants (2027-2029) to support outreach and enrollment for this specific population.

Topics ✓ HealthcareSupports HealthcareCreates Medicare buy-in program expanding health coverage for first responders, ensuring minimum essential coverage under ACA, directly advancing access to healthcare services.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentExpands health care benefits for retired/disabled first responders, enhancing post-employment coverage for a high-risk workforce group.90% confidence

Sub-Topics Insurance Medicaid Medicare Tags Public Safety

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in committee · United States · House Dec 4, 2025

HR 6455: Health Insurance Premium Fairness Act of 2025

This bill changes how the government calculates health insurance tax credits under the Affordable Care Act. It allows households with Medicare coverage to subtract Medicare premiums paid by family members (including Parts A, B, C, D, and supplemental policies) from the tax credit amount they receive. This affects people who qualify for premium tax credits and have household members enrolled in Medicare. The adjustment reduces the credit amount but cannot make it negative, and applies to coverage months starting after December 2025.

Topics ✗ Budget & TaxesOpposes Budget & TaxesReduces tax credit amounts, lowering government spending on ACA subsidies. Directly impacts fiscal management of tax credits, limiting program expenditure.85% confidence ✓ HealthcareSupports HealthcareAdjusts ACA tax credits to account for Medicare premiums, improving financial accuracy for households with Medicare coverage under healthcare financing framework.85% confidence

Sub-Topics Tax Credits Insurance Medicare

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in committee · United States · Senate Jan 8, 2026

S 3607: Access to Genetic Counselor Services Act of 2026

This bill requires Medicare to cover genetic counseling services provided by licensed or certified genetic counselors starting January 2027. It defines covered services and sets payment at 80% of the lower of the actual charge or 85% of the physician fee schedule. Medicare beneficiaries seeking genetic counseling and genetic counselors practicing in licensed or certified states will directly benefit from this expanded coverage. The bill also prohibits balance billing for these services and updates Medicare rules to clarify that physicians may still bill for genetic counseling if covered under existing rules.

Topics ✓ HealthcareSupports HealthcareExpands Medicare coverage for genetic counseling services, requiring 80% reimbursement and prohibiting balance billing, directly improving patient access to specialized care.95% confidence

Sub-Topics Medicare

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in committee · United States · Senate Jun 12, 2025

S 2071: Disaster Relief Medicaid Act

The Disaster Relief Medicaid Act creates a new Medicaid program for survivors of major disasters declared after January 1, 2027. It provides simplified eligibility during a two-year relief coverage period (starting when the disaster is declared), allowing people in affected areas to access medical assistance without meeting standard income requirements. The law includes provisions for continuous eligibility, mental health services, home and community-based care, and 100% federal funding for these services. States must provide streamlined applications and issue special Medicaid cards valid for the entire relief period. It also includes specific protections for children born to survivors and pregnant individuals during the disaster period.

Topics ✓ HealthcareSupports HealthcareCreates new Medicaid program for disaster survivors with simplified eligibility, mental health services, and 100% federal funding, expanding healthcare access and funding.95% confidence

Sub-Topics Long-Term Care Medicaid Medicare Tags Emergency Management

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in committee · United States · House Apr 24, 2025

HR 3023: Preventing Hospital Overbilling of Medicare Act

This bill requires hospitals to bill Medicare and other insurers using separate unique identifiers for off-campus outpatient departments (starting January 1, 2026), rather than treating them as part of the main hospital. It removes exceptions that allowed hospitals to bill higher rates for services at off-campus locations, mandating that these departments use specific billing forms (HIPAA X12 837P or CMS 1500) with their own identifiers. The bill directly affects hospitals operating off-campus departments, Medicare, and health insurance issuers, ensuring claims for these locations are processed accurately. It also directs the National Association of Insurance Commissioners to develop model regulations helping insurers reject improper claims. The key change is standardizing billing to prevent overcharging for off-campus services.

Topics ✓ HealthcareSupports HealthcarePrevents hospital overbilling of Medicare by requiring separate billing for off-campus departments, protecting patients from inflated costs and ensuring Medicare funds are used appropriately.90% confidence

Sub-Topics Hospitals Insurance Medicare

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