Bill Detail
S. 1105
Congress: 119
Title
No UPCODE Act
Summary
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data. Specifically, the bill requires the Centers for Medicare & Medicaid Services (CMS) to use two years of diagnostic data in its risk adjustment methodology for MA payments. It also prohibits the CMS from using diagnoses that are collected from chart reviews or health risk assessments when adjusting payments based on health status. The CMS must also take into account any differences in coding patterns between MA and traditional Medicare when determining MA payment adjustments.
Sponsor
Sen. Bill Cassidy [R-LA]
Status
Read twice and referred to the Committee on Finance.
Status as of Aug 5, 2:54 AM · synced 9d ago
Introduced
2025-03-25
Data source mode: cache
Bill Engagement
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act This bill modifies certain factors that are used to determine Medicare Advantage (MA) pay…
Lobbyists on the case
- American Medical Association4 filings · 27 lobs
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