Healthcare (Medicare)

in committee · United States · Senate Dec 15, 2025

S 3480: Seniors Deserve SMARTER Care Act of 2025

This bill prohibits the implementation of the WISeR model under Medicare, specifically blocking the Secretary of Health and Human Services from adopting the "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model" or any similar model. It directly affects Medicare beneficiaries and providers by preventing a new payment and service delivery approach that would require prior authorization for certain services. The key provision is a direct ban on the WISeR model's rollout, as outlined in the July 1, 2025, federal notice. This change would maintain current Medicare approval processes for affected services without creating new requirements. The bill does not establish new benefits or alter existing Medicare coverage rules.

Topics ✓ HealthcareSupports HealthcareBlocks WISeR model's prior authorization requirements, preventing restrictions on Medicare services and protecting beneficiary access to care.95% confidence

Sub-Topics Long-Term Care Medicare Tags Seniors

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in committee · United States · House Mar 10, 2025

HR 2013: Medicare Home Health Accessibility Act

This bill amends Medicare eligibility rules to clarify that beneficiaries needing occupational therapy *or* speech therapy qualify for home health services. It updates two sections of the Social Security Act (Parts A and B) to replace "need occupational therapy or speech therapy" with "need occupational, or speech therapy," ensuring both therapies are explicitly covered. The change directly affects Medicare beneficiaries requiring either therapy for home-based care, removing potential confusion about eligibility. The updated rules will take effect for services provided on or after January 1, 2026.

Topics ✓ HealthcareSupports HealthcareBill clarifies Medicare eligibility to explicitly cover both occupational and speech therapy, removing confusion and improving access to home health services for beneficiaries.95% confidence

Sub-Topics Long-Term Care Medicare

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in committee · United States · Senate May 12, 2025

S 1717: Ensuring Patient Access to Critical Breakthrough Products Act of 2025

S 1717, the Ensuring Patient Access to Critical Breakthrough Products Act of 2025, requires Medicare to cover FDA-designated "breakthrough" medical devices during a 4-year transitional period starting when the device is approved. This directly affects Medicare beneficiaries (Part A/B enrollees) and device manufacturers, ensuring coverage for these innovative products while FDA reviews their safety. The bill mandates that Medicare’s coverage decisions for these devices must be finalized within 9-12 months before the 4-year period ends, and allows coverage denial only if clinical data shows the device poses undue risk. It also allocates $10 million annually (2026-2031) to fund Medicare’s implementation of these coverage rules.

Topics ✓ HealthcareSupports HealthcareMandates Medicare coverage for FDA-designated breakthrough devices, expanding patient access to innovative medical products during transitional period.95% confidence

Sub-Topics Medicare Telehealth

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in committee · United States · House Jan 14, 2025

HR 307: ARC Act of 2025

HR 307, the ARC Act of 2025, aims to reduce avoidable amputations by expanding access to peripheral artery disease (PAD) screening and prevention. It requires Medicare and Medicaid to cover PAD screening tests (like ankle-brachial index tests) without cost-sharing for at-risk beneficiaries, including seniors, diabetics, and those with other vascular risk factors. The bill also establishes a federal education program to raise awareness about PAD and creates quality measures to incentivize hospitals to prioritize non-amputation treatments through early detection. These provisions directly affect millions of Americans, particularly minorities disproportionately impacted by PAD-related amputations, by making preventive care more accessible and integrated into routine care.

Topics ✓ HealthcareSupports HealthcareExpands Medicare/Medicaid coverage for PAD screening without cost-sharing for at-risk groups, directly advancing preventive healthcare access and reducing barriers for vulnerable populations.95% confidence

Sub-Topics Medicaid Medicare Primary Care

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in committee · United States · Senate Sep 17, 2025

S 2830: WELL Seniors Act of 2025

The WELL Seniors Act of 2025 expands Medicare's annual wellness visit program to better address seniors' health and social needs. It requires screenings for fall risk and assessments of food security, housing, transportation, and social support, with providers receiving a 10% payment incentive for including at least two additional elements beyond standard care. The bill also allows these visits to be provided via telehealth and adds physical therapists, occupational therapists, and pharmacists as eligible providers starting in 2026. Additionally, it mandates a national education campaign and research study to improve uptake, particularly for low-income and rural seniors.

Topics ✓ HealthcareSupports HealthcareExpands Medicare wellness visits with social need screenings and provider incentives, improving senior healthcare access and comprehensive care services.95% confidence

Sub-Topics Long-Term Care Medicare Telehealth Tags Seniors

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in committee · United States · House Jan 15, 2026

HR 6182: Find It Early Act

The Find It Early Act requires most health insurance plans, Medicare, Medicaid, TRICARE, and VA benefits to cover certain breast cancer screenings without cost-sharing for specific at-risk groups. It affects individuals at increased breast cancer risk (as determined by medical guidelines), those with dense breast tissue (as defined by the American College of Radiology), and others requiring screening due to factors like age, race, ethnicity, or family history. The bill mandates coverage for various screening methods including mammograms, ultrasounds, MRI, and other technologies at frequencies recommended by the National Comprehensive Cancer Network. This requirement takes effect for plan years beginning January 1, 2026, removing financial barriers to early detection.

Topics ✓ HealthcareSupports HealthcareMandates no-cost coverage for breast cancer screenings for at-risk groups, expanding access to preventive care without cost-sharing as required by medical guidelines.95% confidence ✓ VeteransSupports VeteransMandates VA benefits cover breast cancer screenings without cost-sharing, directly improving veterans' healthcare access under VA benefits.95% confidence

Sub-Topics Insurance Medicaid Medicare

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in committee · United States · Senate Dec 4, 2025

S 3345: PBM Price Transparency and Accountability Act

The PBM Price Transparency and Accountability Act requires pharmacy benefit managers (PBMs) to be more transparent about drug pricing and ensure accurate payments to pharmacies. It establishes national average drug acquisition cost benchmarks for Medicaid, prohibits PBMs from keeping excessive profits through "spread pricing," and mandates detailed reporting of drug pricing, rebates, and fees. The bill affects Medicaid programs, Medicare Part D plans, and the PBMs that negotiate drug prices on behalf of insurers. It includes enforcement mechanisms like civil penalties for non-compliance and requires PBMs to report detailed pricing information to the Secretary of Health and Human Services.

Topics ✓ HealthcareSupports HealthcareRequires PBM transparency, prohibits spread pricing, and mandates reporting to lower drug costs and improve patient access under Medicaid/Medicare programs.92% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

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in committee · United States · Senate Nov 20, 2025

S 3267: ASAP Act

S 3267, the ASAP Act, would require Medicare to cover early detection screening tests for Alzheimer's disease and related dementias starting January 1, 2028. The bill defines these tests as FDA-cleared or approved blood, genomic, or imaging-based screenings for pre-symptomatic or early-stage detection. It directly affects Medicare beneficiaries aged 65+ who may be at risk for Alzheimer's, ensuring coverage for these specific tests once approved. The key provision adds these screenings to Medicare's payment system under Section 1833(h)(1)(A) of the Social Security Act.

Topics ✓ HealthcareSupports HealthcareRequires Medicare to cover Alzheimer's early detection screenings, expanding preventive care access for seniors 65+ through new coverage provisions.95% confidence

Sub-Topics Medicare

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in committee · United States · Senate Mar 19, 2026

S 2833: Stand Strong Falls Prevention Act

The Stand Strong Falls Prevention Act establishes an Advisory Committee on Falls Prevention within the Older Americans Act to coordinate federal efforts targeting falls among older adults. The committee will develop a national falls prevention plan, assess current federal programs (including Medicare and Medicaid initiatives), and recommend evidence-based interventions like home modifications and screening tools. It requires annual reports to Congress evaluating program effectiveness, progress on reducing falls-related injuries, and recommendations for expanding successful pilots. The bill directly affects federal agencies, Medicare beneficiaries, and older adults at risk of falls, focusing on concrete policy coordination rather than new funding or mandates.

Topics ✓ HealthcareSupports HealthcareEstablishes advisory committee under Older Americans Act to coordinate falls prevention, assess Medicare/Medicaid programs, and recommend evidence-based interventions like home modifications.95% confidence

Sub-Topics Long-Term Care Medicaid Medicare

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in committee · United States · Senate Dec 11, 2025

S 3442: Metastatic Breast Cancer Access to Care Act

This bill removes waiting periods for disability and Medicare benefits for people diagnosed with metastatic breast cancer. Specifically, it amends the Social Security Act to add "metastatic breast cancer" to the list of conditions that immediately qualify individuals for disability insurance benefits (eliminating a standard 24-month waiting period) and for Medicare coverage (removing a 24-month waiting period for Medicare Part A). The changes apply only to new applications or benefit periods starting after the bill becomes law. It directly affects patients with metastatic breast cancer seeking timely access to income support and healthcare coverage.

Topics ✓ HealthcareSupports HealthcareRemoves 24-month waiting periods for Medicare/disability benefits for metastatic breast cancer patients, immediately expanding access to healthcare coverage.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentRemoves 24-month waiting period for disability/Medicare benefits, expanding access to critical worker benefits for metastatic breast cancer patients under Social Security Act.95% confidence

Sub-Topics Medicare

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