No Medicare Clawbacks Act of 2026
Sponsored By: Representative Torres, Ritchie [D-NY-15]
Introduced
Summary
Bars retroactive clawbacks by group health plans for Medicare Part A services. This bill would stop group health plans from recouping payments they already made when a beneficiary later gets retroactive Part A coverage and the beneficiary was current on employee contributions at the time the service was furnished.
Show full summary
- People with Medicare Part A and retroactive coverage would be protected from plan demands to repay benefits if they were not behind on employee contributions when care was provided.
- Group health plans and insurers would be barred from recovering payments they initially made without regard to Part A entitlement in those specific cases.
- Plan administrators would need to adjust recovery and claims procedures to avoid prohibited recoupments.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Stop group plan Medicare clawbacks
If enacted, this bill would bar a group health plan from later recouping a payment it already made for a service. This would apply when you are entitled to Medicare Part A under section 226(a), are enrolled in the group plan, and the plan initially paid without regard to your Part A entitlement. It would only protect services furnished during a period of retroactive Part A coverage and only if you were current on any employee contributions when the service was given. If enacted, plans would not be able to take back those payments on the basis of your Part A entitlement.
Sponsors & CoSponsors
Sponsor
Torres, Ritchie [D-NY-15]
NY • D
Cosponsors
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 6/29/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov