Save MEDICARE Act of 2026
Sponsored By: Representative Doggett, Lloyd [D-TX-37]
In Committee
Summary
Would prohibit Medicare Advantage plans from offering provider financial incentives tied to coding of services. The ban covers percentage-of-premium contracts and other incentives linked to how items and services are coded for enrollees. It would apply to plan years beginning on or after January 1, 2028 and includes related compliance and enforcement mechanics.
Show full summary
- Providers would no longer be eligible for percentage-of-premium or other coding-related financial incentives under Medicare Advantage contracts.
- Enrollees would not have their billed items and services used to trigger coding-based pay incentives for their providers.
- Medicare Advantage plans must remove these incentive structures and follow new compliance and enforcement measures tied to the prohibition.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 1 benefits, 1 costs, 2 mixed.
Stronger RADV audits and fees
If enacted, for plan years beginning January 1, 2028 the Secretary would hire recovery audit contractors to find and recoup Medicare Advantage overpayments. CMS could extrapolate audited sample results to whole plans and apply them retroactively. Penalties would equal the full overpayment plus interest and RADV audits would face strict deadlines for reviews and reconsiderations. Payments to MA organizations would be reduced by 0.02 percent to fund RADV audits, and recovery contractors' contingency fees would be capped at 20 percent of recouped amounts.
Change Medicare Advantage payments
If enacted, the Secretary would change how Medicare Advantage area base payments and benchmarks are calculated starting in 2028. The Secretary would multiply the statutory base payment by a MedPAC-derived "selection percentage" and use 2025 and later data so results can change base payments for 2029 and after. Area benchmarks would be based on the adjusted statutory base payment and would account for phasing out indirect medical education costs and exclude kidney transplant organ acquisition payments. For payments and bids applicable to 2028 and later, diagnoses found only by chart reviews or health risk assessments would not be used, the Secretary would identify diagnosis codes prone to variable coding, and MA contracts starting January 1, 2028 would ban provider pay tied to coding.
VA reimbursement from MA and Part D
If enacted, for MA and Part D plan years starting January 1, 2028 MA organizations and drug plan sponsors would have to reimburse the VA when the VA provides covered care to one of their enrollees. Reimbursements would go to the VA Medical Care Collections Fund. Third parties must report whether a recipient got VA benefits within 30 days and pay clean claims or agreed amounts within 45 days or owe interest at the Treasury rate. The Secretary must provide requested information within 45 days and third parties must pay within 15 days after receiving it. Settlement proceeds cannot be distributed until the VA claim is satisfied, and refund requests are barred after 18 months.
States can enforce MA rules
If enacted, each State could require Medicare Advantage plans sold or offered in the State to meet Part C rules. The Secretary would have to coordinate enforcement with the State where an MA organization is licensed and any State where it issues or sells plans. The Secretary could enter into collaborative enforcement agreements with States.
Sponsors & CoSponsors
Sponsor
Doggett, Lloyd [D-TX-37]
TX • D
Cosponsors
Rep. Ansari, Yassamin [D-AZ-3]
AZ • D
Sponsored 6/30/2026
Rep. Balint, Becca [D-VT-At Large]
VT • D
Sponsored 6/30/2026
Rep. Casar, Greg [D-TX-35]
TX • D
Sponsored 6/30/2026
Rep. Chu, Judy [D-CA-28]
CA • D
Sponsored 6/30/2026
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 6/30/2026
Rep. Cleaver, Emanuel [D-MO-5]
MO • D
Sponsored 6/30/2026
Rep. Cohen, Steve [D-TN-9]
TN • D
Sponsored 6/30/2026
Rep. Davis, Danny K. [D-IL-7]
IL • D
Sponsored 6/30/2026
Rep. DeLauro, Rosa L. [D-CT-3]
CT • D
Sponsored 6/30/2026
Rep. Deluzio, Christopher R. [D-PA-17]
PA • D
Sponsored 6/30/2026
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 6/30/2026
Rep. Garamendi, John [D-CA-8]
CA • D
Sponsored 6/30/2026
Rep. García, Jesús G. "Chuy" [D-IL-4]
IL • D
Sponsored 6/30/2026
Rep. Garcia, Robert [D-CA-42]
CA • D
Sponsored 6/30/2026
Rep. Grijalva, Adelita S. [D-AZ-7]
AZ • D
Sponsored 6/30/2026
Rep. Huffman, Jared [D-CA-2]
CA • D
Sponsored 6/30/2026
Rep. Jackson, Jonathan L. [D-IL-1]
IL • D
Sponsored 6/30/2026
Rep. Jayapal, Pramila [D-WA-7]
WA • D
Sponsored 6/30/2026
Rep. Johnson, Henry C. "Hank" [D-GA-4]
GA • D
Sponsored 6/30/2026
Rep. Khanna, Ro [D-CA-17]
CA • D
Sponsored 6/30/2026
Rep. Mfume, Kweisi [D-MD-7]
MD • D
Sponsored 6/30/2026
Rep. Nadler, Jerrold [D-NY-12]
NY • D
Sponsored 6/30/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 6/30/2026
Rep. Ocasio-Cortez, Alexandria [D-NY-14]
NY • D
Sponsored 6/30/2026
Rep. Omar, Ilhan [D-MN-5]
MN • D
Sponsored 6/30/2026
Rep. Pingree, Chellie [D-ME-1]
ME • D
Sponsored 6/30/2026
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 6/30/2026
Rep. Randall, Emily [D-WA-6]
WA • D
Sponsored 6/30/2026
Rep. Schakowsky, Janice D. [D-IL-9]
IL • D
Sponsored 6/30/2026
Rep. Scott, Robert C. "Bobby" [D-VA-3]
VA • D
Sponsored 6/30/2026
Rep. Smith, Adam [D-WA-9]
WA • D
Sponsored 6/30/2026
Rep. Takano, Mark [D-CA-39]
CA • D
Sponsored 6/30/2026
Rep. Thanedar, Shri [D-MI-13]
MI • D
Sponsored 6/30/2026
Rep. Thompson, Bennie G. [D-MS-2]
MS • D
Sponsored 6/30/2026
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 6/30/2026
Rep. Velázquez, Nydia M. [D-NY-7]
NY • D
Sponsored 6/30/2026
Rep. Waters, Maxine [D-CA-43]
CA • D
Sponsored 6/30/2026
Rep. Watson Coleman, Bonnie [D-NJ-12]
NJ • D
Sponsored 6/30/2026
Rep. Green, Al [D-TX-9]
TX • D
Sponsored 6/30/2026
Rep. Carson, André [D-IN-7]
IN • D
Sponsored 6/30/2026
Rep. McGovern, James P. [D-MA-2]
MA • D
Sponsored 6/30/2026
Rep. Tokuda, Jill N. [D-HI-2]
HI • D
Sponsored 6/30/2026
Rep. DeSaulnier, Mark [D-CA-10]
CA • D
Sponsored 6/30/2026
Rep. Krishnamoorthi, Raja [D-IL-8]
IL • D
Sponsored 7/2/2026
Rep. Menefee, Christian D. [D-TX-18]
TX • D
Sponsored 7/2/2026
Rep. Ramirez, Delia C. [D-IL-3]
IL • D
Sponsored 7/2/2026
Rep. Latimer, George [D-NY-16]
NY • D
Sponsored 7/6/2026
Rep. Williams, Nikema [D-GA-5]
GA • D
Sponsored 7/6/2026
Rep. Adams, Alma S. [D-NC-12]
NC • D
Sponsored 7/14/2026
Rep. Meng, Grace [D-NY-6]
NY • D
Sponsored 7/14/2026
Rep. Hoyle, Val T. [D-OR-4]
OR • D
Sponsored 7/15/2026
Rep. Dexter, Maxine [D-OR-3]
OR • D
Sponsored 7/20/2026
Roll Call Votes
No roll call votes available for this bill.
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