Health Hearing: Legislative Proposals to Support Patient Access to Medicare Services

Health

2026-01-08

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Source: Congress.gov

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walkers, diabetic supplies, just to name a few.  However, the way Medicare reimburses for these products can be improved.
Dr. Joyce from Pennsylvania is leading HR 1703, the Choices for Increased Mobility Act, which creates a new billing code to improve Medicare coverage for ultra-lightweight wheelchairs.
particularly those made from titanium or carbon fiber.  Currently, an individual must pay full price for the upgrade to a lighter, more functional wheelchair and then hope to get reimbursed by Medicare later.
This bill would allow Medicare to cover a portion of the costs up front to ease the financial burden on individuals.
M
Ms. Susan Van Meter
Another bill, HR 2477, the Portable Ultrasound Reimbursement Equity Act, led by Representative Van Dyne from Texas, provides Medicare reimbursement for portable ultrasound transportation
and services which will help seniors get the care they need.
Representative Miller Meeks from Iowa champions HR 2005.  The DMEPOS, also known as Demi-Pose Relief Act, would establish a fair rate for DME supplies.
The way DME products get priced is through a process known as competitive bidding.  This is where DME suppliers bid to be the sole contractor in a certain area of the country   with the winning bid prices used to determine supplier reimbursement.  These prices are not one size fits all, and suppliers, especially in some areas, struggle to stay open due to these low rates.  This bill aims to help mitigate that impact.  The last bill in the DME space is H.R.  2902, the Supplemental Oxygen Access Reform Act, led by Representative Valdeo from California.  Among other things, this bill removes supplemental oxygen and its supplies from the competitive bidding program   and creates a new reimbursement rate for supplemental and liquid oxygen.  We will also be considering HR 2172, the Preserving Patient Access to Home Infusion Act, led by Representative Buchanan from Florida.  This bill would make updates to the home infusion therapy benefit and support patient access to this benefit.  The current reimbursement structure is not aligned with how these therapies are currently administered in the home.  This bill will modernize the model, ensure adequate provider reimbursement,   and support patient access to home infusions.  Another bill being considered today is H.R.
5269, the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act, led by our own Richard Hudson from North Carolina.  This bill would update how CMS establishes reimbursement rates for clinical laboratory services paid under Medicare clinical lab fee schedule.   This important bill aims to create a less burdensome process for CMS to determine private payer-based rates for lab services.
A few other bills being considered today include HR 5243, led by Representative McClellan from Virginia, that brings more transparency into supplemental benefits provided by Medicare Advantage plans.
The Healthcare Efficiency Through Flexibility Act, also led by Representative Buchanan.   This bill would extend certain methods for collecting accountable care organizations' quality measurement data, as well as establish a digital quality measure pilot program.
HR 6210, the Senior Savings Protection Act, led by Representative Matsui from California, reauthorizes and funds certain programs under the Medicare Improvements for Patients and Providers Act.
These programs help low-income beneficiaries understand and access their benefits.
Lastly, we will discuss H.R.
6361, the Ban AI Denials in Medicare Act, led by Representative Landsman from Ohio.  This bill prohibits the Center for Medicare and Medicaid Innovation, or CMMI, from implementing the wasteful and inappropriate service reduction model, or the WISER model.  While I understand the concerns around AI and prior authorization, CMMI's statutory mission is to lower healthcare costs and improve outcomes for patients.   The WISER model does not change Medicare coverage policy, but will focus on ensuring that for a set of non-emergency services, seniors are getting safe, effective, and appropriate care.
I look forward to hearing from our witnesses today and working to advance these bills to a markup.  I now recognize the subcommittee ranking member, Representative DeGette, for five minutes for an opening statement.
Representative DeGette?
Thank you very much, Mr. Chairman, and I will say I'm glad that this committee is finally having another hearing, and I'm glad we're bringing up some bills that overall we can agree on in a bipartisan way.
But I hate to tell you, Rome is still burning.  Alarm bells have been ringing for health care affordability for months, and with the expiration of enhanced premium tax credits at the end of 2025, we knew that premiums
would skyrocket in 2026.
Millions of Americans who get health insurance through the ACA were notified last year that their premiums were doubling or more.  They are now trying to figure out how to pay for coverage this year or if they're going to take the terrifying step of going without insurance that has become too expensive.
And they're also wondering if Congress will finally step in to save them from these skyrocketing premiums.
In my district, for example, a family of four making $128,000 a year, this is teachers, nurses, farmers, small business owners, got hit   with an average $14,000 increase in their silver plan premiums, but the majority has done nothing to help.

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