S 1105 ยท No UPCODE Act
Read twice and referred to the Committee on Finance.
- Introduced
- Mar 25, 2025
- Latest action
- Mar 25, 2025
- Sponsor
- Sen. Bill Cassidy [R-LA]
- Policy area
- Health
- Cosponsors
- 1
Summary
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data. Specifically, the bill requires the Centers for Medicare & Medicaid Services (CMS) to use two years of diagnostic data in its risk adjustment methodology for MA payments. It also prohibits the CMS from using diagnoses that are collected from chart reviews or health risk assessments when adjusting payments based on health status. The CMS must also take into account any differences in coding patterns between MA and traditional Medicare when determining MA payment adjustments.
Recent actions
- Mar 25, 2025 Read twice and referred to the Committee on Finance.
- Mar 25, 2025 Introduced in Senate
Votes
No recorded votes are available for this bill.