# 119-s-1105: No UPCODE Act

119-s-1105, No UPCODE Act, is a 119th Congress bill sponsored by Sen. Cassidy, Bill [R-LA] (R-LA); status introduced; PRIA reads it as touching household money (as of 2025-12-21).

- Canonical: https://policyrisk.com/legislation/119-s-1105
- As of: 2025-12-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-1105
- Congress: 119
- Title: No UPCODE Act
- Status: introduced
- Introduced: 2025-03-25
- Sponsor: Sen. Cassidy, Bill [R-LA] (R-LA)
- Cosponsors: 1
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2025-12-21

## Summary

**Would change how Medicare Advantage risk adjustment uses diagnoses and coding patterns.** Beginning in 2026 it would require CMS to use two years of diagnostic data for risk scores, bar diagnoses gathered from chart reviews and health risk assessments from being used for payment adjustments, and require annual evaluation and public reporting of coding pattern differences with adjustments to risk models that may be plan- or contract-level. - Medicare Advantage enrollees: Risk scores that help determine plan payments would be calculated from two years of diagnostic data starting in 2026. - Medicare Advantage plans: Diagnoses collected from chart reviews or health risk assessments could not be used to increase payment adjustments, and CMS would need procedures to identify and verify those diagnoses. - Centers for Medicare & Medicaid Services and the Medicare program: CMS would have to evaluate coding pattern differences each year, publicly report the results, and adjust the risk adjustment methodology to fully account for those differences, possibly with plan- or contract-level adjustments.

## Cosponsors (1)

- Sen. Merkley, Jeff [D-OR] (D-OR), 2025-03-25T00:00:00.000Z

## Provisions PRIA read

- Medicare Advantage coding and payments: mixed, low. If enacted, the bill would require the Secretary (CMS) to use two years of diagnosis data for Medicare Advantage risk scores starting in 2026. Diagnoses found only by chart reviews or health risk assessments would not count for payment adjustments, and CMS would set procedures to identify those dia…

## Related bills

- 119-s-4744: Take Care of America’s Veterans Act
- 119-s-2120: Older Americans Act Reauthorization Act of 2025
- 119-s-836: Children and Teens’ Online Privacy Protection Act
- 119-s-93: Harmful Algal Bloom and Hypoxia Research and Control Amendments Act of 2025
- 119-s-3257: John A. Hauser Mental Health in Aviation Act
- 119-s-3940: Access to Fair Financing for Opportunity and Resilient Development Act

## Sources
- [119-s-1105 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/1105)

## Related
- [119-s-4744: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-s-4744)
- [119-s-2120: Older Americans Act Reauthorization Act of 2025](https://policyrisk.com/legislation/119-s-2120)
- [119-s-836: Children and Teens’ Online Privacy Protection Act](https://policyrisk.com/legislation/119-s-836)
- [119-s-93: Harmful Algal Bloom and Hypoxia Research and Control Amendments Act of 2025](https://policyrisk.com/legislation/119-s-93)
- [119-s-3257: John A. Hauser Mental Health in Aviation Act](https://policyrisk.com/legislation/119-s-3257)
- [119-s-3940: Access to Fair Financing for Opportunity and Resilient Development Act](https://policyrisk.com/legislation/119-s-3940)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-1105 (as of 2025-12-21).