# 119-s-891: Bipartisan Health Care Act 119-s-891, Bipartisan Health Care Act, is a 119th Congress bill sponsored by Sen. Wyden, Ron [D-OR] (D-OR); status introduced; PRIA reads it as touching household money (as of 2026-08-13). - Canonical: https://policyrisk.com/legislation/119-s-891 - As of: 2026-08-13 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: 119-s-891 - Congress: 119 - Title: Bipartisan Health Care Act - Status: introduced - Introduced: 2025-03-06 - Sponsor: Sen. Wyden, Ron [D-OR] (D-OR) - Cosponsors: 1 - Policy area: Health - Touches household money: yes - Last recorded action: 2026-08-13 ## Summary **PBM transparency and 100% rebate pass-through** is the bill's center piece, forcing middlemen to disclose pricing and remit rebates while also expanding Medicaid/Medicare supports and public‑health investments. - Families, caregivers, and home‑based care: creates Home and Community‑Based Services (HCBS) planning grants up to $5.0 million per grant for up to 10 States and appropriates $71.0 million for FY2025 with $50.0 million reserved for grants. States must report waiting lists and service‑level timeliness for key personal‑care services. - Seniors and Medicare enrollees: extends telehealth flexibilities through Dec 31, 2026 and Acute Hospital Care at Home through Dec 31, 2029. Adjusts Part D low‑income cost sharing toward $0 generics by 2027 and requires more accurate Medicare Advantage provider directories. - Pharmacies, PBMs, and plans: imposes machine‑readable, claim‑level PBM reporting, authorizes audits, and requires 100% pass‑through of rebates for new/renewed contracts beginning ~30 months after enactment. Provides implementation funding including $188.0 million to CMS and $20.0 million to HHS OIG for FY2025. *Adds multiple targeted appropriations and ongoing program spending across Medicaid, Medicare, PBM oversight, and public health, increasing federal outlays in the near term.* ## Cosponsors (1) - Sen. Sanders, Bernard [I-VT] (I-VT), 2025-03-06T00:00:00.000Z ## Provisions PRIA read - Medicare coverage for multi-cancer tests: benefit, high. If enacted, Medicare Part B would cover certain FDA-cleared multi-cancer early detection blood tests furnished on or after January 1, 2029. Tests must meet FDA criteria and the Secretary would use the national coverage process. Payment rules set transitional rates through 2031 and limit payments by… - Big boost to public health preparedness: benefit, high. If enacted, the bill would strengthen national preparedness. It adds plans for diagnostics and replenishment, funds the Strategic National Stockpile ($1.1 billion for FY2025 and $1.21 billion for FY2026), increases CDC facility funding, and provides several billion to community health centers and t… - More funding for addiction and mental health: benefit, high. If enacted, the bill would sharply expand grant authority and training for substance use and related public health programs. It would authorize about $505.6 million per year for overdose detection and response grants (fiscal years 2025–2029), allow legal distribution of overdose test strips where l… - Stronger public health preparedness funding: benefit, high. If enacted, the bill would boost and extend public health preparedness programs. It would authorize large, year-specific amounts for State medical stockpiles (about $3.4 billion for FY2025 and $3.265 billion for FY2026) and extend preparedness program funding and surveillance work through 2026. It… - Ban spread pricing in Medicaid: benefit, high. If enacted, State Medicaid contracts that cover outpatient drugs (for contracts starting 18 months after enactment) would have to use pass-through pricing: pay ingredient cost plus a dispensing fee and pass payments through to pharmacies. Administrative fees must reflect fair market value. Spread p… - Behavioral health and recovery grants: benefit, medium. If enacted, the bill would expand and fund behavioral health programs. It would redesignate and enlarge the child traumatic stress initiative with multi-year funding from FY2025 through FY2029. Grants for treatment, recovery, and workforce supports would be reauthorized with higher funding and up t… - Fairer living organ donor pay rules: benefit, medium. If enacted, grant recipients that reimburse living organ donors could not consider the organ recipient's income when deciding donor reimbursement. The bill would remove any expectation that recipients must pay donors and require annual reports starting in fiscal year 2026 on whether donors received… - Lower Medicare drug costs and coverage: benefit, medium. If enacted, the bill would lower out-of-pocket caps for low-income Part D enrollees (e.g., $1 copays for many generics before 2027 and $0 for generics from 2027). It would extend certain oral antiviral coverage in Part D through December 31, 2025. It would also let Medicare cover some external infu… - Medicaid residency and HCBS protections: benefit, medium. If enacted, starting January 1, 2028, States would treat active duty relocated service members and their dependents as State residents for Medicaid unless they opt out. If a relocated person is on an HCBS waiting list, they would stay on it until the State completes assessment and any appeals. The… - Medicare Advantage directory rules: benefit, medium. If enacted, Medicare Advantage plans would have to keep provider directories accurate starting with plan year 2027. Plans must verify listings at least every 90 days, remove providers who leave within five business days, and limit enrollee cost-sharing if a directory error caused out-of-network cha… - More cancer, dental, and pediatric funding: benefit, medium. If enacted, the bill would raise funding for cancer screening, dental public-health work, pediatric drug studies, and diabetes programs. The breast and cervical cancer program would be authorized at $235.5 million per year for 2025–2029. Action for Dental Health would get $15 million per year and p… - More maternal health research and support: benefit, medium. If enacted, the bill would fund new maternal research and share best practices to reduce maternal deaths. It would authorize $100 million per year for maternal mortality prevention in 2025–2029. States would study maternity costs and the bill would provide $10 million in grants and $3 million for i… - More Medicare telehealth access: benefit, medium. If enacted, the bill would extend several temporary Medicare telehealth flexibilities through late 2026 and postpone some in-person rules until 2027. Phone-only visits, expanded practitioner types, and relaxed geography rules would mostly be allowed through December 31, 2026. Telehealth would also… - Online suppliers for Medicare prevention: benefit, medium. If enacted, the bill would let entities enroll as Medicare Diabetes Prevention Program suppliers that offer only online services from January 1, 2026 through December 31, 2030. Administrative addresses must match program records and claims may be submitted across state lines. There would be no limi… - Stronger disability and senior crisis protections: benefit, medium. If enacted, HHS would issue guidance to make crisis standards of care follow disability and age nondiscrimination laws within two years. The bill would also fund outreach and assistance to older Americans for a limited period and update certain advisory committees and task forces. These changes aim… - More training and hiring paths for responders: benefit, medium. If enacted, first responders would get broader training (not limited to opioids) and higher annual funding. Grants would fund reduced administrative burdens for health workers. Fellows who finish eligible programs could be noncompetitively converted into career federal jobs. - Keep HSA status when telehealth is free: benefit, medium. If enacted, a plan would still count as a high‑deductible health plan for HSA eligibility even if it had no telehealth deductible for certain months and plan years listed in the bill. This preserves HSA tax benefits for affected enrollees. - ERISA safe harbor for missed remittances: benefit, medium. If enacted, responsible ERISA plan fiduciaries could get a safe harbor when a covered service provider fails to remit required amounts, if the fiduciary reasonably believed remittance occurred, requests payment in writing, and notifies the Secretary if unpaid after 90 days. The safe harbor starts f… - Public health labs and preparedness: benefit, medium. If enacted, the bill would fund and coordinate public health labs, surveillance, and preparedness. It would authorize regional biocontainment laboratories and wastewater surveillance grants for FY2025–2026, improve cybersecurity for the 9‑8‑8 mental health lifeline, require an FDA opioid assessment… - More drug price and PBM transparency: benefit, medium. If enacted, group health plans and PBMs would have to report detailed drug and claim data. Plans must report drugs with over $10,000 in plan spending (or the top 50 drugs). Reports would include PBM compensation, pharmacy payments, net prices after rebates, participant out‑of‑pocket costs, and ther… - More youth prevention and school grants: benefit, medium. If enacted, grants would fund broader youth prevention in secondary schools and include education about synthetic opioids like fentanyl. Grants could go to local education consortia and must include sustainment plans. Appropriations rise from $10 million in FY2025 to $15 million in FY2029. - Cap on patents in biosimilar suits: benefit, medium. If enacted, a reference biologic sponsor would generally be limited to asserting up to 20 patents in a suit against a biosimilar applicant. No more than 10 of those patents may have issued after a specified date. Courts can raise the limit for good cause. The rule applies to biosimilar applications… - More respite help for unpaid caregivers: benefit, low. If enacted, the Lifespan Respite program would expand the definition of family caregiver to include unpaid individuals who are not adults and would be authorized for fiscal years 2025 through 2029. This could let more unpaid caregivers get respite supports. - New FASD supports and clearinghouse: benefit, low. If enacted, the bill would create or continue a federal program to prevent and treat fetal alcohol spectrum disorders (FASD). The government could fund a national clearinghouse for FASD resources, public education, screening expansion, and technical help. Family-to-Family information centers would… - New filing windows for COVID claims: benefit, low. If enacted, people injured by COVID‑19 countermeasures could file under a new 3‑year window (or within one year after enactment, if later). Previously denied claims for being late could be refiled, and officials must notify claimants so they can switch to the counterpart claim within one year of no… - Pharmacies can deliver to prescribers: benefit, low. If enacted, the bill would let pharmacies deliver certain Schedule III, IV, or V drugs directly to the prescribing practitioner when those drugs are to be injected or implanted for maintenance or detoxification, or when a REMS requires post-use monitoring by a provider. This change takes effect upo… - Sickle cell grants and treatment funding: benefit, low. If enacted, the bill would expand sickle cell program activities to focus on treatment and prevention of complications and authorize $8,205,000 each year for 2025 through 2029 for grants, contracts, or cooperative agreements to support those activities. - Telehealth guidance for limited English: benefit, low. If enacted, HHS would issue guidance within one year on telehealth best practices for people with limited English. The guidance would cover using interpreters in virtual visits, giving instructions and patient portals in multiple languages, and sharing prescription information in other languages. - Temporary 180-day FDA enforcement delay: benefit, low. If enacted, the bill would block certain FDA enforcement actions under PREA/505B for failures that occurred before the date 180 days after enactment. Enforcement would only apply to failures that occur on or after that 180‑day date. This gives regulated sponsors a transition window before certain p… - Guidance for at‑home drug disposal: benefit, low. If enacted, HHS and the DEA would publish guidance within one year on standards and instructions for at‑home safe drug disposal systems. The guidance would include best practices and education for manufacturers, providers, and consumers. - Quarterly checks to stop dead provider payments: benefit, low. If enacted, States would have to check the Death Master File at least every quarter when enrolling or revalidating health care providers starting January 1, 2027. The check is to stop enrollments and payments to deceased providers. - Study of new drug R&D funding models: benefit, low. If enacted, the Secretary would hire the National Academies within 90 days to study prize and other models that delink research costs from drug prices. The study must hold at least two public listening sessions and report within two years. - WTC Health Program funding rules: benefit, low. If enacted, the bill would set a formula for World Trade Center Health Program funding for fiscal years 2026 through 2040. Each year would equal the prior year's amount times 1.05 and an enrollment-ratio factor. The Secretary would also produce a budget assessment and a long-term projections report… - Narrower vaccine injury remedies: cost, low. If enacted, the bill would bar compensation under a specific vaccine-remedy section if the vaccine was on the Vaccine Injury Table when given. It would also require that a covered individual submit all supporting documents before being considered to have exhausted remedies under the cited process. - New transplant network registration fees: cost, low. If enacted, the Secretary could charge members of the Organ Procurement and Transplantation Network a registration fee for each transplant candidate they add to the national list. The fees must fund OPTN operations and would expire three years after enactment. The government must publish collection… - Medicaid access and program changes: mixed, high. If enacted, the bill would make several Medicaid and CHIP changes. It would let eligible people age 65 and older join certain Medicaid buy-in groups immediately on enactment. States would have to check the Death Master File at least quarterly starting January 1, 2026 and disenroll people listed as… - Big investments in pandemic preparedness: mixed, high. If enacted, the bill would boost research and preparedness funding for countermeasures, including up to $950 million for each of 2025 and 2026 and $735 million for preparedness in 2025–2026. It would add leaders to federal planning bodies, require better allocation plans, and extend certain voucher… - Medicare payment boosts and sequester plan: mixed, high. If enacted, the bill would raise several Medicare payment authorities: add a higher APM incentive for 2027, increase a temporary physician fee schedule boost for part of 2025, and raise the Medicare Improvement Fund to $1.938 billion per year. At the same time, it sets a general Medicare payment re… - Drug treatment funding and scheduling changes: mixed, medium. If enacted, the bill would raise annual funding for SUD workforce loan repayment and community recovery grants for 2025–2029. It would also extend temporary scheduling for fentanyl‑related substances and lengthen the opioid scheduling review horizon. HHS and DOJ would review buprenorphine/naloxone… - Medicare billing, audits, and studies: mixed, medium. If enacted, the bill would add several Medicare billing and program integrity steps. Some durable medical equipment and laboratory items may face more prepayment review starting January 1, 2028. The HHS Inspector General would report on Part B lab fraud risks by January 1, 2026. CMS would get money… - Delay juvenile justice Medicaid rule: mixed, medium. If enacted, States would not be treated as failing to comply with juvenile justice screening, referral, and case management Medicaid/CHIP requirements before January 1, 2026. States must submit an interim work plan to HHS by June 30, 2025. The rule excludes people in Federal custody from those requ… - Medicare provider payments and rules: mixed, medium. If enacted, the bill would extend the Hospital Care at Home pathway through December 31, 2029 and require related data and a study. It would delay some payment or index changes, extend ambulance and low-volume hospital add-ons, and change Medicare-Dependent Hospital dates. At the same time, Medicar… - FDA review and pediatric drug rules: mixed, medium. If enacted, the bill would change FDA review and information rules for drugs. Generic applicants could ask FDA whether a proposed product has the same inactive ingredients and FDA would have to disclose differences. The bill would require FDA guidance on pediatric molecularly targeted cancer studie… - PBM reporting for employer plans: mixed, medium. If enacted, PBM vendors for group health plans would have to give detailed reports to plans at least every six months, starting about 30 months after enactment. Reports would show per-drug prices, rebates, claim counts, and participant out-of-pocket totals. Employers and plans could use the data to… - Pediatric drug rules and vouchers: mixed, medium. If enacted, the bill would change pediatric study rules, requiring molecularly targeted pediatric cancer investigations for some applications filed three years after enactment and adding reporting milestones. It would extend the rare pediatric disease priority review voucher program through Septemb… - Pharmacy access and PBM rules: mixed, medium. If enacted, Medicare plans and regulators would get new pharmacy access and PBM rules. The bill would require PBMs to report detailed drug- and revenue-level data starting for plan years beginning January 1, 2028. PBMs would generally be limited to bona fide service fees and must repay money kept u… - Pediatric study timing and penalties reporting: mixed, low. If enacted, new pediatric study rules (505B) would only apply to drug applications filed three years after enactment. The FDA would also have to report penalties, settlements, or payments for failures to meet pediatric study requirements, naming the drug, sponsor, and amount. ## Related bills - 119-s-5071: Children's Safe Welcome Act of 2026 - 119-s-2819: Head Start for America's Children Act - 119-s-4504: Full-Service Community School Expansion Act of 2026 - 119-s-3990: PrEP Access and Coverage Act of 2026 - 119-s-2823: FAMILY Act - 119-s-2763: Keep Billionaires Out of Social Security Act ## Sources - [119-s-891 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/891) ## Related - [119-s-5071: Children's Safe Welcome Act of 2026](https://policyrisk.com/legislation/119-s-5071) - [119-s-2819: Head Start for America's Children Act](https://policyrisk.com/legislation/119-s-2819) - [119-s-4504: Full-Service Community School Expansion Act of 2026](https://policyrisk.com/legislation/119-s-4504) - [119-s-3990: PrEP Access and Coverage Act of 2026](https://policyrisk.com/legislation/119-s-3990) - [119-s-2823: FAMILY Act](https://policyrisk.com/legislation/119-s-2823) - [119-s-2763: Keep Billionaires Out of Social Security Act](https://policyrisk.com/legislation/119-s-2763) - [All bills in Congress](https://policyrisk.com/legislation) Source: PRIA, https://policyrisk.com/legislation/119-s-891 (as of 2026-08-13).