HR3580119th CongressWALLET

Oversight of Medicare Billing Code Cost Act

Sponsored By: Representative Ciscomani

Introduced

Summary

Transparency and oversight of Medicare billing code changes. This bill would require the HHS Office of Inspector General to study how the Centers for Medicare & Medicaid Services adds, modifies, and removes Medicare billing codes and to recommend administrative or legislative changes. It would also require CMS to publish each year a list of billing codes added in the prior year along with the associated volume and expenditures.

Show full summary
  • Families and researchers: would gain public data on new Medicare billing codes and the spending tied to them, making it easier to track cost and outcome trends.
  • Providers and specialties: the Inspector General study would analyze trends in codes added, modified, removed, or revalued and identify areas with the highest growth.
  • Congress and policymakers: the HHS Office of Inspector General would submit a report with findings and recommendations within 12 months, and CMS would publish annual lists beginning in 2025.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Public reports and oversight of Medicare billing codes

If enacted, the HHS Inspector General would study how CMS adds, changes, and removes Medicare billing codes. The Inspector General would send Congress a report with findings and recommendations within 12 months after enactment. Starting in 2025, HHS would publish by June 1 each year a CMS report listing billing codes added in the prior year, with how often they were used and how much Medicare paid. The annual report would be sent to Congress and posted on the CMS website. This would increase transparency and oversight and would not change who qualifies for Medicare or payment rates today.

Sponsors & CoSponsors

Sponsor

Ciscomani

AZ • R

Cosponsors

  • Smucker

    PA • R

    Sponsored 5/23/2025

  • Harshbarger

    TN • R

    Sponsored 5/23/2025

Roll Call Votes

No roll call votes available for this bill.

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