This bill establishes a Medicare Advance Directive Certification Program to help Medicare beneficiaries create and manage legally recognized advance directives that outline their medical care preferences. The program would require participating vendors to meet strict accreditation standards for security, privacy, and accessibility while allowing beneficiaries to voluntarily enroll and update their documents online. Key provisions include mandatory notifications to Medicare enrollees, federal oversight of vendor compliance, and the availability of state-compliant advance directive forms on the Centers for Medicare & Medicaid Services website. The legislation does not preempt state laws and ensures that certified directives remain accessible to healthcare providers and designated family members when needed.
This bill creates a Medicare buy-in option for individuals aged 50 to 64 who would qualify for Medicare at age 65 but are not yet eligible, allowing them to enroll in Medicare Parts A, B, and D with premiums based on average costs and geographic adjustments. It also establishes a new voluntary supplemental insurance program for current Medicare beneficiaries to help cover deductibles and copayments, starting in 2027, and requires the government to negotiate lower drug prices for Medicare Part D plans beginning in 2029. The legislation creates a reinsurance fund to stabilize health insurance premiums in the individual market for high-cost enrollees starting in 2025 and extends risk corridor reauthorization through 2031. Additionally, the bill increases eligibility for premium tax credits to cover individuals with household incomes up to 400% of the poverty line and repeals certain reconciliation provisions from a previous law.
The STOP FRAUD in Medicaid Act expands the scope of Medicaid fraud investigations by directing state Medicaid fraud control units to examine not just providers but also individuals who apply for or receive benefits. This change requires states to investigate and prosecute fraudulent activities involving both healthcare providers and beneficiaries seeking or receiving Medicaid coverage. The bill amends existing federal law to explicitly include individuals in the definition of entities subject to fraud control unit oversight. These provisions take effect 180 days after the law is enacted, giving states time to adjust their investigation procedures.
This bill would allow certain oral contraceptive drugs to be sold over-the-counter to adults aged 18 and older by requiring the FDA to prioritize their review and waive associated application fees. It specifically excludes emergency contraceptives and drugs also approved for induced abortion from these provisions. The legislation also directs the Government Accountability Office to study how federal programs fund contraception over the past 15 years, covering Medicare, Medicaid, and other health services.
This bill, known as the Diabetes Foot Health Access and Modernization Act of 2026, makes two main changes to federal health insurance programs. First, it allows podiatric physicians to provide covered physician services under Medicaid, ensuring patients have access to specialized foot and ankle care. Second, it updates Medicare rules to clarify documentation requirements for diabetic shoes, specifying that a physician must confirm a patient has diabetes and related foot conditions before these shoes are covered. The changes take effect on January 1, 2026 for Medicaid podiatry services and January 1, 2028 for Medicare diabetic shoe documentation.
This bill, the PrEP Access and Coverage Act of 2026, requires most health insurance plans to cover HIV prevention medication without charging patients any cost-sharing fees. It directly affects people enrolled in private insurance, Medicare, Medicaid, and other government health programs by mandating that these plans cover the medication, related lab tests, and follow-up care without requiring prior approval. The law also prohibits insurance companies from denying life, disability, or long-term care insurance to individuals taking HIV prevention medication and requires a public education campaign to increase awareness about the medication.
This bill requires the Secretary of Health and Human Services to create a two-year demonstration program that would make certain wound care treatments mandatory for Medicaid coverage for people with epidermolysis bullosa. The program would include over-the-counter medications, antiseptics, antibiotic ointments, and specific wound care supplies such as dressings and bandages. It would operate nationwide and require states to include these items and services in their Medicaid plans or waivers. At the end of the program, the Secretary must submit a report to Congress evaluating the program's impact on treatment costs and health outcomes, along with recommendations on preventing hospitalizations.
This bill, known as the Diabetes Foot Health Access and Modernization Act of 2026, makes two main changes to federal healthcare programs. First, it allows Medicaid to cover foot and ankle care services provided by podiatric physicians, ensuring patients have access to this specialized care. Second, it updates Medicare rules to clarify documentation requirements for diabetic shoes, specifying conditions under which patients can receive extra-depth or custom-molded footwear. The changes take effect on January 1, 2026, for Medicaid services and January 1, 2028, for Medicare shoe coverage.
This bill, titled the Combating Deceptive Practices in Assistance Programs Act of 2026, modifies Medicaid eligibility requirements for personal care services. It directly affects individuals seeking assistance with daily living activities under the Medicaid program. The key provision adds a specific eligibility criterion requiring applicants to be unable to perform at least three activities of daily living as defined in the Internal Revenue Code. These changes would take effect for medical assistance provided on or after January 12, 2027.
This bill, known as the State Veterans Homes Inspection Simplification Act, would allow certain State Veterans Homes that are already certified by the Department of Veterans Affairs to be automatically considered compliant with Medicare and Medicaid nursing home standards. Under this proposal, facilities meeting specific VA inspection and certification requirements would not need to undergo separate reviews by the Centers for Medicare & Medicaid Services, reducing duplication of effort. The legislation maintains oversight by requiring the VA to submit its inspection standards for review every two years, allowing CMS to conduct targeted surveys or complaints investigations, and mandating public reporting of inspection data on the Nursing Home Care Compare website. A Government Accountability Office report would be required three years after enactment to evaluate the bill's impact on survey efficiency, enforcement outcomes, and resident care quality.