Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for c…
Amends Medicare (Title XVIII) to tighten claims rules for certain durable medical equipment and supplies (DME): requires electronic claims submission, shortens the time to file claims for defined “specified items” to 90 days (with enumerated exceptions), and directs the Government Accountability Office to report on Medicare Administrative Contractors’ screening technology for those items by January 1, 2030. “Specified items” are DME on the Medicare Master List furnished on or after January 1, 2027. The bill excludes items subject to face-to-face, written-order, prior authorization, or monthly rental rules from the 90-day requirement.
Progressives stress beneficiary access and protections.
Relative to its intended legislative type, this bill is a targeted substantive statutory amendment that also includes a reporting requirement.
Amends Medicare (Title XVIII) to tighten claims rules for certain durable medical equipment and supplies (DME): requires electronic claims submission, shortens the time to file claims for defined “specified items” to 90 days (with enumerated exceptions), and directs the Government Accountability Office to report on Medicare Administrative Contractors’ screening technology for those items by January 1, 2030. “Specified items” are DME on the Medicare Master List furnished on or after January 1, 2027.
The bill excludes items subject to face-to-face, written-order, prior authorization, or monthly rental rules from the 90-day requirement.
Technical, low‑cost Medicare integrity measure with bipartisan potential, but affected suppliers, timing, and procedural barriers lower chances absent inclusion in a larger legislative vehicle.
Relative to its intended legislative type, this bill is a targeted substantive statutory amendment that also includes a reporting requirement. It specifies concrete changes to claims submission methods and deadlines for a defined subset of durable medical equipment and supplies and directs a GAO review of screening technologies.
Progressives stress beneficiary access and protections.
These are examples from the analysis, not a ranked list of the most-affected groups.
Progressives stress beneficiary access and protections.
Generally supportive of stronger program integrity to protect taxpayer funds and beneficiary access, but cautious about implementation risks.
Will want safeguards so fraud-fighting does not deny needed equipment to vulnerable beneficiaries.
Favors program-integrity measures if implemented pragmatically.
Will weigh efficiency and fraud reduction against administrative cost and disruption to patient care.
Generally favorable toward stronger fraud prevention and tighter claims controls to protect Medicare resources.
Concerned about federal mandates that impose paperwork or harm provider reimbursement if overbroad.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Technical, low‑cost Medicare integrity measure with bipartisan potential, but affected suppliers, timing, and procedural barriers lower chances absent inclusion in a larger legislative vehicle.
The bill has not accumulated any surfaced votes yet.
Progressives stress beneficiary access and protections.
Technical, low‑cost Medicare integrity measure with bipartisan potential, but affected suppliers, timing, and procedural barriers lower cha…
Relative to its intended legislative type, this bill is a targeted substantive statutory amendment that also includes a reporting requirement. It specifies concrete changes to claims submission methods and deadlines for…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.