HR7336119th CongressWALLET

ALS Better Care Act

Sponsored By: Representative Schakowsky

Introduced

Summary

Medicare coverage for ALS-related services would be created so people with amyotrophic lateral sclerosis can get coordinated, ALS-specific care under a single, dedicated payment model. The bill would also set payment rules and require recurring Comptroller General reports plus a separate short report on ALS clinical trial administration.

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  • Patients & families: Covers a bundle of ALS services including specialized physician or nurse practitioner support, occupational and physical therapy, speech pathology, dietary and respiratory support, registered nurse services, and coordination of durable medical equipment. No cost sharing is allowed.
  • Providers: Establishes a 'qualified provider' category to furnish ALS-related services and receive a single per-visit payment. Payments require an ALS ICD-10-CM diagnosis code and can include adjustments for providers participating in NIH clinical trials.
  • Medicare payments & oversight: Sets a base per-visit payment of $800 for 2027 and $800 for 2028, then ties later increases to an ALS services market basket and to Comptroller General recommendations every three years. The Comptroller General would publish an initial report by January 1, 2027 and then every third year to recommend payment amounts.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

New Medicare ALS outpatient payments

If enacted, Medicare would cover a new bundled category called "ALS-related services" for outpatient care starting January 1, 2027. The bill would pay a single per-visit amount to qualified providers and would ban cost sharing for beneficiaries. The base payment would be $800 in 2027 and $800 in 2028 unless the Comptroller General recommends a higher amount; later years would be updated by an ALS services market basket or by Comptroller General recommendations in certain years. Providers must bill using the ALS ICD-10 code, the Secretary would set qualified-provider rules through notice-and-comment rulemaking, and outpatient department payments would still apply where allowed.

Report on ALS clinical trial staffing

If enacted, the Secretary of HHS would have to publish a report within 90 days about administration and staffing challenges for ALS clinical trials. The report would be prepared through the NINDS Director and published on the agency website. It would list actions NINDS can take and include any legislative recommendations and requests for appropriations to improve trial administration.

Sponsors & CoSponsors

Sponsor

Schakowsky

IL • D

Cosponsors

  • Fitzpatrick

    PA • R

    Sponsored 2/3/2026

  • Crow

    CO • D

    Sponsored 2/3/2026

  • Quigley

    IL • D

    Sponsored 2/3/2026

  • Bacon

    NE • R

    Sponsored 2/20/2026

  • Morelle

    NY • D

    Sponsored 2/20/2026

Roll Call Votes

No roll call votes available for this bill.

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