The Community Health Worker Access Act would add community health services to Medicare Part B starting in 2027, allowing beneficiaries to receive these services without paying a deductible and with costs covered at 100 percent of the lesser of the actual charge or a government-set fee schedule. The bill defines eligible services as preventive care and support for social determinants of health, such as transportation assistance, case management, and culturally specific outreach, provided by qualified community health agencies under the supervision of licensed medical providers. Additionally, it gives states an optional pathway to cover similar services through Medicaid, offering a 6 percentage point increase in federal matching funds to help offset state costs for these workforce-supported programs.
The Net Effective Cost Transparency and Prescription Drug Affordability Act of 2026 requires Medicare Part D and Advantage plans to use a standardized public bidding process for pharmacy benefit managers starting in 2028, ensuring that the lowest projected net effective cost is generally selected. The bill mandates that plan sponsors maintain real-time tools to track actual drug costs and escrow funds to refund enrollees if they are overcharged relative to their bids. It also establishes a new five-star rating system for these plans based on how closely actual spending matches projections, with low-performing plans required to notify beneficiaries of alternative options. Additionally, the legislation extends similar transparency requirements to commercial health plans by requiring them to disclose projected net effective costs in their bid submissions.
The Health Care Accountability Mission Act of 2026 allows the Secretary of Health and Human Services to impose civil monetary penalties on for-profit hospitals, critical access hospitals, and rural emergency hospitals that repeatedly fail to meet safety standards in ways that immediately jeopardize patient health. Specifically, a penalty of up to $10,000 per day may be assessed if a hospital has received a similar determination within the previous two years. The bill requires these determinations to be published on a public website maintained by the Centers for Medicare & Medicaid Services and applies existing procedural rules for civil monetary penalties to this new provision.
The Equity in STI Testing Act requires Medicare Advantage, Medicaid, CHIP, TRICARE, and the Department of Veterans Affairs to cover screening tests for HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia without charging beneficiaries any out-of-pocket costs. The bill directly affects patients enrolled in these federal health programs by eliminating copayments and deductibles specifically for these preventive screenings. It also mandates that the Indian Health Service provide these tests to eligible Native Americans at no cost, regardless of whether the services are typically authorized under their purchased or referred care systems. These changes take effect on different timelines depending on the specific program, with some provisions applying immediately upon enactment and others starting in the following calendar year.
The Screen to Save Act requires Medicare, Medicaid, and private health insurance plans to cover annual screening mammography for women aged 30 and older at no cost to the patient. This change takes effect on January 1, 2027, and specifically prohibits insurers from charging copays or deductibles for these screenings. The bill also establishes a frequency limit that prevents Medicare from paying for mammograms performed within 11 months of a previous screening for women over 29.
The GREEN Hospitals Act authorizes $100 billion in Hill-Burton grants for hospitals and other medical facilities to upgrade their infrastructure for climate resilience and emissions reduction. It also establishes a separate $5 billion Planning and Evaluation Grant Program that provides up to $500,000 per project to help states, tribes, and nonprofits develop sustainability plans before construction begins. To receive funding, applicants must demonstrate labor protections, including collective bargaining agreements or non-interference policies, and certify they do not impose training repayment debts on employees. The bill prioritizes projects in environmental justice communities and those serving high numbers of Medicare and Medicaid patients, requiring that at least half of the planning grant funds be directed to these areas.
This bill amends Medicare to cover dental and oral health services for the first time, affecting all current and future Medicare beneficiaries. It defines covered services to include routine cleanings, fillings, extractions, root canals, crowns, dentures, and emergency care. For most individuals, federal payment for these services will gradually increase from 0% to 80% over an eight-year period, while low-income individuals eligible for prescription drug subsidies will receive 80% coverage immediately. The legislation also establishes frequency limits, such as two cleanings and exams per year and a five-year limit on full dentures, and requires the U.S. Preventive Services Task Force to include at least one oral health professional.
The Part D Premium Protection Act of 2026 would establish a temporary premium credit for Medicare Part D prescription drug plan enrollees in 2027. This credit is designed to match the average premium reduction observed during the Part D Premium Stabilization Demonstration program between January 1, 2025, and the end of 2026. Under the bill's provisions, insurance sponsors would charge enrollees their standard premiums minus this specific credit amount, with the floor set at zero dollars. The Secretary of Health and Human Services would then reimburse the sponsors for the difference between the charged premium and the full applicable rate.
The Local Health Care Protection Act of 2026 allows certain hospitals to continue participating in the federal drug discount program, known as Section 340B, even if they no longer meet specific financial thresholds related to serving low-income patients. This provision applies to hospitals that were already eligible for the program on July 3, 2025, and protects their access to discounted medications through cost reporting periods ending by September 30, 2030. The bill directly affects rural and underserved hospitals that may lose eligibility due to changes in Medicaid funding or Medicare payment formulas. Additionally, it requires the Government Accountability Office to conduct a study within one year on how these financial criteria are calculated and how declining payments impact essential health services in rural areas.
The Cancer Care Planning and Communications Act amends Medicare rules to cover new "cancer care planning and coordination services" for beneficiaries diagnosed with cancer. These services require a physician, nurse practitioner, or physician assistant to create a written or electronic treatment plan that addresses medical needs, cultural preferences, and follow-up care at key stages such as diagnosis, the end of active treatment, or disease recurrence. To support this requirement, the bill establishes a specific payment rate for these planning visits, setting it equal to the existing reimbursement for transitional care management services.
