This resolution expresses support for the Trump administration's efforts to combat fraud, waste, and abuse in Medicare, Medicaid, and other federal health care programs. It highlights specific actions taken, such as using advanced technology to detect fraud, suspending billions of dollars in suspected fraudulent payments, and coordinating with law enforcement to prosecute offenders. The document also acknowledges the creation of a new task force designed to lead a governmentwide strategy against fraud in federal benefit programs. Ultimately, the bill serves as a formal recognition of these initiatives rather than introducing new laws or policy changes.
The Legalizing Premium Health Care Act of 2026 allows Medicare beneficiaries to sign written contracts with doctors or other eligible professionals to receive services at agreed-upon rates that may exceed standard Medicare limits. Under this bill, patients who sign such contracts would be responsible for paying the difference between the contracted amount and what Medicare covers, while also handling their own claims unless they choose to delegate this task to the provider. The legislation prohibits these agreements during medical emergencies or urgent situations and prevents states from setting their own caps on the charges these professionals can bill. Additionally, the act explicitly excludes individuals who qualify for both Medicare and Medicaid from entering into these private payment arrangements.
The Medicare Advantage Improvement Act of 2026 aims to speed up care decisions and increase transparency for Medicare Advantage enrollees and providers. Starting in 2028, the bill requires insurance plans to respond to most prior authorization requests within 72 hours and to provide real-time decisions for low-risk services, while also banning requirements for re-authorization when a treatment plan is clinically modified. The legislation introduces a new compliance scoring system that will publicly rank plans and reduce payments to those with poor performance, alongside stricter rules ensuring medical necessity standards match those of traditional Medicare.
The Health Savings Account Expansion Act modifies tax rules to allow individuals with government-sponsored health plans, such as Medicare or Medicaid, and those in health care sharing ministries to contribute to Health Savings Accounts. It also clarifies that payments for these specific types of coverage can be made using HSA funds and expands the definition of eligible medical expenses to include membership fees and administrative costs for health care sharing ministries. Additionally, the bill permits the use of HSA funds to purchase over-the-counter drugs and insulin without a prescription. These changes are scheduled to take effect for taxable years beginning after December 31, 2026.
The Medicare Advantage Improvement Act of 2026 aims to speed up care decisions and increase transparency for Medicare Advantage enrollees by establishing strict time limits for insurance plan responses to requests for coverage authorization. Beginning in 2028, plans must provide real-time approvals for low-risk services, respond to other authorization requests within 72 hours, and automatically pay claims for authorized services without manual review. The bill also prohibits plans from requiring new authorizations for clinically necessary changes to already approved treatments and mandates that medical necessity standards match those used in traditional Medicare. To ensure accountability, the legislation introduces a new compliance scoring system that could reduce payments to plans failing to meet these requirements and adds a specific domain to the public star ratings based on adherence to these rules.
This bill, known as the Medicare Payment Integrity Enhancement Act of 2026, allows contractors hired to audit Medicare claims to review them before payments are made. Under current rules, these auditors can only check claims after money has already been sent out, but this legislation would expand their authority to stop improper payments in advance. To support this new role, the bill changes how these contractors are paid by linking their compensation to the amount of money they successfully prevent from being paid out incorrectly. Additionally, it requires the government to create a specific funding plan that transfers money from Medicare trust funds to cover these prepayment review costs. The law also mandates that the health department issue rules within a year to explain exactly how contractor pay and savings calculations will work.
The Medicare Access to Radiology Care Act of 2026 allows Medicare to pay for services provided by radiologist assistants, who are certified professionals working under the direct supervision of a radiologist. This legislation defines these services as those legally permitted by state law and ensures that payment goes to the supervising radiologist rather than the assistant. The bill applies to services rendered in hospitals, ambulatory surgical centers, and other specified facility settings starting on January 1, 2027. By adding radiologist assistant services to the list of covered benefits, the act aims to expand access to diagnostic imaging while maintaining the existing requirement that assistants operate within a radiologist-led team.
The SURS Extension Act extends the Small Practice, Underserved, and Rural Support Program through fiscal year 2031. This program provides financial incentives to healthcare providers who treat patients in rural areas or underserved communities. By amending the Social Security Act, the bill ensures these payments continue for six additional years. The measure directly affects small medical practices and facilities that serve high-need populations.
The SAFE through Medicare Act expands Medicare coverage to include specific home resiliency services for individuals deemed medically at-risk during climate or manmade disasters. This bill defines these services as medically necessary items, such as heat pumps, solar batteries, and energy-efficient cold storage, that help vulnerable people cope with extreme weather events like heat waves, cold snaps, or flooding. To determine eligibility, the Secretary of Health and Human Services will establish a process considering factors like geographic climate risks, local disaster history, and a patient's reliance on temperature-sensitive medical equipment or power-dependent devices. If approved, Medicare will cover 100 percent of the cost for these services, provided they are furnished on or after January 1, 2027.
The Rural MOMS Act of 2026 modifies how Medicare counts hospital beds, specifically excluding labor and delivery rooms from the total number of acute care inpatient beds used to determine if a facility qualifies as a Critical Access Hospital. This change directly affects rural hospitals that provide maternity services by altering the financial thresholds required to maintain their special status under the Medicare program. By removing delivery rooms from the bed count calculation, the bill aims to prevent these facilities from losing their designation solely because they offer childbirth care. The legislation does not change how these hospitals are funded or operated, but rather adjusts the metric used to evaluate their eligibility for critical access benefits.
