Healthcare (Medicare)

in committee · United States · Senate Jun 24, 2026

S 4886: Medicare Cost Cap Act of 2026

The Medicare Cost Cap Act of 2026 establishes a $5,000 annual limit on out-of-pocket costs for Medicare fee-for-service beneficiaries starting in 2028, after which Medicare will cover 100% of additional covered expenses. This protection applies to all individuals enrolled in Medicare Part A or Part B and includes tracking mechanisms to notify patients and providers once the cap is reached. The bill also modifies eligibility rules for low-income assistance programs, aligning income thresholds between Medicare Savings Programs and Medicaid and expanding data sharing to streamline enrollment for qualifying beneficiaries.

Topics ✓ HealthcareSupports HealthcareBill caps out-of-pocket costs for Medicare beneficiaries, protecting patients from high expenses and strengthening financial access to healthcare services.95% confidence

Sub-Topics Medicaid Medicare

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in committee · United States · House Jun 30, 2026

HR 9538: Residential Recovery for Seniors Act

The Residential Recovery for Seniors Act expands Medicare coverage to include three specific levels of residential treatment for substance use disorders: clinically managed low-intensity, clinically managed high-intensity, and medically managed services. To qualify for this coverage, facilities must meet strict standards regarding staffing, clinical assessments, and adherence to evidence-based criteria developed by recognized medical associations. The bill also establishes a new payment system that reimburses these facilities on a per-day basis, starting in fiscal year 2027, with rates initially set to cover 100% of their estimated costs.

Topics ✓ HealthcareSupports HealthcareBill expands Medicare coverage for substance use disorder treatment and establishes new payment systems, directly advancing healthcare access and funding.95% confidence

Sub-Topics Medicare Substance Abuse

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in committee · United States · House Jul 21, 2026

HR 9390: Prices on the Wall Act of 2026

The Prices on the Wall Act of 2026 requires hospitals, ambulatory surgical centers, laboratories, and imaging providers across the United States to display specific pricing information on their walls starting in 2028. This law mandates that these facilities post discounted cash prices for a list of services designated by the Centers for Medicare & Medicaid Services, or if those prices are unavailable, the median amount charged to self-pay patients over the previous three years. The displayed prices must be located in areas specified by the Secretary of Health and Human Services to ensure patients can see costs before receiving care. By making these financial details publicly visible, the bill aims to increase price transparency for consumers seeking scheduled medical services.

Topics ✓ HealthcareSupports HealthcareBill mandates transparent pricing display to improve patient access and reduce cost uncertainty.85% confidence

Sub-Topics Medicaid Medicare

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in committee · United States · Senate Jul 16, 2026

SJRES 198: A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model".

This joint resolution seeks to officially disapprove a specific rule issued by the Centers for Medicare & Medicaid Services regarding the implementation of prior authorization for certain Medicare services. The proposed action would prevent the rule, known as the WISeR Model, from taking effect, thereby stopping the new requirements from being enforced. If passed, the resolution would nullify the regulation and maintain the status quo for the affected healthcare services.

Topics ✗ HealthcareOpposes HealthcareBill blocks a rule intended to reduce wasteful services, thereby restricting efforts to limit unnecessary care and potentially increasing costs.95% confidence

Sub-Topics Medicaid Medicare

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in committee · United States · House Jun 30, 2026

HRES 1403: Expressing the sense of Congress that Medicaid is an important lifeline for the health care of millions of Americans.

This resolution expresses the sense of Congress that Medicaid is a vital lifeline for the health care of millions of Americans, including older adults, people with disabilities, and low-income families. It highlights concerns that recent legislation will cut funding and impose new eligibility rules and paperwork requirements, which could negatively impact access to care. While the bill itself does not change laws or allocate money, it urges the Centers for Medicare & Medicaid Services to provide immediate guidance to state agencies and enrollees regarding these upcoming changes.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill advocates for Medicaid funding and opposes cuts, aligning with protecting essential government services.85% confidence ✓ HealthcareSupports HealthcareBill explicitly calls Medicaid a vital lifeline and urges protection against funding cuts and eligibility restrictions.90% confidence

Sub-Topics Long-Term Care Medicaid Medicare

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in committee · United States · House Jun 25, 2026

HR 9392: Medicare Advantage Cost Transparency Act

The Medicare Advantage Cost Transparency Act requires Medicare Advantage plans to include specific cost details in their data submissions starting in 2027. This change mandates that records show the allowed amount for services and the exact cost-sharing amounts, such as deductibles and copayments, that patients must pay. Additionally, the bill requires plans to note whether a patient received an at-home health risk assessment from a company related to the plan or from an independent provider. The primary goal is to increase financial clarity for individuals enrolled in Medicare Advantage plans by making billing information more transparent.

Topics ✓ HealthcareSupports HealthcareBill enhances cost transparency for Medicare Advantage, protecting patient rights and improving access to clear pricing information.85% confidence

Sub-Topics Medicare Tags Government Transparency

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in committee · United States · House Jul 15, 2026

HR 9468: STAR Act

The Saving Today's Acute-Care Resources Act modifies how Medicare calculates payment rates for long-term care hospitals to ensure they receive appropriate funding for treating complex patients. Starting in fiscal year 2027, the bill expands the criteria for avoiding payment reductions by adding a "high acuity" standard that considers patients transferred from acute care or critical access hospitals with severe diagnoses. It also updates existing rules to include discharges from long-term care hospitals that have undergone significant construction projects or hold state certificates of need. These changes aim to adjust reimbursement levels based on the severity of patient conditions and the specific history of the hospital treating them.

Topics ✓ HealthcareSupports HealthcareBill ensures appropriate Medicare funding for long-term care hospitals treating complex patients, protecting healthcare resources.90% confidence

Sub-Topics Hospitals Long-Term Care Medicare

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in committee · United States · House Jun 24, 2026

HR 9422: Medicaid RAC Improvement Act of 2026

The Medicaid RAC Improvement Act of 2026 strengthens oversight of the Medicaid Recovery Audit Contractor program to better detect and recover incorrect payments. It requires the Centers for Medicare and Medicaid Services to establish clear communication rules for when state program exceptions expire and mandates detailed annual reports on audit results, including amounts recovered and underpayments. The bill also expands the program to include Medicaid managed care plans, requiring these organizations to allow audits of their claims and cooperate with recovery efforts. Additionally, the legislation directs the government to study barriers preventing states from participating in the program and to run a five-year demonstration project to increase state involvement. Finally, it clarifies that audits can review payments made up to four years prior to the current fiscal year.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill strengthens fiscal oversight and recovers incorrect Medicaid payments, promoting fiscal responsibility and protecting state budgets.85% confidence ✓ HealthcareSupports HealthcareBill strengthens oversight to recover incorrect payments, improving program integrity and protecting taxpayer funds for healthcare services.85% confidence

Sub-Topics Audits & Accountability Medicaid Medicare Substance Abuse

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in committee · United States · House Jun 29, 2026

HR 9509: Kidney Disease Education Access Expansion Act of 2026

The Kidney Disease Education Access Expansion Act of 2026 expands Medicare coverage to include kidney disease education services for individuals with hypertension, diabetes, or any stage of chronic kidney disease, rather than limiting them to those with advanced disease. This bill broadens the range of eligible providers to include community health workers and clinical social workers, allows these services to be delivered in group settings or with caregivers present, and adds new topics such as transition assistance for transplant recipients. Starting in 2027, the law also requires private health insurance plans to cover these education services and establishes a working group to develop methods for measuring the effectiveness of the program.

Topics ✓ HealthcareSupports HealthcareBill expands Medicare coverage and broadens eligible providers for kidney disease education, improving patient access to care.95% confidence

Sub-Topics Insurance Medicare

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in committee · United States · House Jun 30, 2026

HR 9502: Protect Seniors and Veterans from Health Care Fraud Act of 2026

This bill requires the Department of Veterans Affairs to create a data-sharing agreement with the Department of Health and Human Services to prevent duplicate or incorrect medical billing for veterans. Under this arrangement, the two agencies would exchange information about veterans who are enrolled in both the VA system and Medicare, Medicaid, or Medicare Advantage plans to identify and stop improper payments. The agreement would last for two years, and the VA must report to Congress on how effective the data sharing is at reducing billing errors.

Topics ✓ HealthcareSupports HealthcareBill aims to prevent duplicate billing and stop improper payments, thereby protecting veterans' financial interests and ensuring accurate healthcare delivery.95% confidence ✓ VeteransSupports VeteransBill mandates data sharing to prevent duplicate billing and stop improper payments, directly protecting veterans from financial fraud and ensuring accurate healthcare benefits.90% confidence

Sub-Topics Medicaid Medicare Veteran Benefits Veteran Education Veteran Healthcare

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