Heard on the Hill

Overview

NAACOS aims to create and maintain the most beneficial legislative environment for ACOs. This is accomplished through constant communication, education, and advocacy with lawmakers and their staff. Congressional briefings, hearings, letters and in-person meetings are tools to share the positions of NAACOS and our members.

119^th Congress: Legislative Tracker

Topic	Bill & Status	Summary	Sponsors	Positions
eCQM	Healthcare Efficiency Through Flexibility Act (H.R. 483)	Delays mandatory eCQM reporting until 2030 Maintains all quality reporting options, including Web Interface Requires CMS to establish pilot test for eCQM reporting prior to mandatory transition	Reps. Vern Buchanan (R-FL); Dan Crenshaw (R-TX); Jimmy Panetta (D-CA) House Cosponsor List	Support
APM Incentives	Preserving Patient Access to Accountable Care Act (H.R. 786/ S.1460)	Extends Medicare’s AAPM incentives at 3.53 percent for payment year 2027 Maintains 2024 revenue and patient thresholds for qualifying APM status	Reps. Darin LaHood (R-IL); Neal Dunn (R-FL); Suzan DelBene (D-WA); Kim Schrier (D-WA) House Cosponsor List Sens. John Barrasso (R-WY); Sheldon Whitehouse (D-RI); Bill Cassidy (R-LA); Peter Welch (D-VT); Thom Tillis (R-NC); Marsha Blackburn (R-TN) Senate Cosponsor List	Support
Medicare Extenders	Lower Costs for Everyday Americans Act (H.R. 1768) Bipartisan Health Care Act (S. 891)	Extends various Medicare extenders (telehealth, hospital at home, community health center funding) Extends Medicare’s AAPM incentives at 3.53 percent for payment year 2027 Maintains 2024 revenue and patient thresholds for qualifying APM status	Rep. Frank Pallone (D-NJ) House Cosponsor List Sen. Ron Wyden (D-OR) Senate Cosponsor List	Support
Physician Payment	Medicare Patient Access and Practice Stabilization Act (H.R. 879)	Stops the 2.83 percent payment cut for physicians Provides physicians with a 2 percent payment update for the remainder of 2025 (April 1- Dec. 31)	Reps. Greg Murphy (R-NC); Mariannette Miller-Meeks (R-IA); Claudia Tenney (R-NY); Carol Miller (R-WV); John Joyce (R-PA); Jimmy Panetta (D-CA); Kim Schrier, MD (D-WA); Raja Krishnamoorthi (D-IL); Ami Bera (D-CA); Raul Ruiz (D-CA) House Cosponsor List	Support
Physician Payment	Medicare Patient Access and Practice Stabilization Act (S. 1640)	Stops the 2.83 percent payment cut for physicians Provides physicians with an 8.51 percent payment update for the remainder of 2025 (June1- Dec. 31)	Sens. Roger Marshall (R-KS); Adam Schiff (D-CA) Senate Cosponsor List	Support
Budget Reconciliation	One Big Beautiful Bill Act (H.R. 1) Signed into law July 4, 2025	Medicaid Reduces Medicaid funding by $1 trillion May eliminate coverage for 10 million people Imposes new work requirements on ACA expansion population Requires more frequent eligibility redeterminations Increases cost sharing for certain populations and services Places a moratorium on new provider taxes for all states and reduces the tax threshold for ACA expansion states Reduces the cap on Medicaid State Directed Payments Adds $50 billion to rural health fund to help states with lost Medicaid funding Medicare Increases Medicare physician fee schedule conversion factor by 2.5% for 2026 to offset portion of previous payment cuts Tax/HSA Imposes new eligibility verification requirements for Advance Premium Tax Credits (APTC) and allows enhanced APTCs to expire at the end of 2025 Allows high-deductible plans to offer telehealth coverage pre-deductible Allows direct primary care arrangements with HSAs	Rep. Jodey Arrington (R-TX)	*Neutral* Supportive of Medicare payment update Concerned about impact of Medicaid changes
Prior Authorization	Improving Seniors’ Timely Access to Care Act (H.R. 3514 / S. 1816)	Establishes an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments Increase transparency around MA prior authorization requirements	Reps. Mike Kelly (R-PA); Suzan DelBene (D-WA) House Cosponsor List Sens. Mark Warner (D-VA); Roger Marshall (R-KS) Senate Cosponsor List	Support
Hospital at Home	Hospital Inpatient Services Modernization Act (H.R.4313/ S. 2237)	Extends the Acute Hospital Care at Home Waivers for five years	Reps. Vern Buchanan (R-FL); Lloyd Smucker (R-PA); Dwight Evens (D-PA) House Cosponsor List Sens. Tim Scott (R-SC); Raphael Warnock (D-GA) Senate Cosponsor List	Support
Medicare Advantage	No UPCODE Act (S.1105)	Requires CMS to use two years of diagnostic data in risk adjustment methodology for MA payments Prohibits CMS from using diagnoses that are collected from chart reviews or health risk assessments when adjusting payments based on health status Requires CMS to account for any differences in coding patterns between MA and traditional Medicare when determining MA payment adjustments	Sens. Bill Cassidy (R-LA); Jeff Merkley (D-OR) Senate Cosponsor List	*Neutral* Previous support for using two years of data Concerned with health risk assessment provisions; supports excluding in-home primary care Support for risk adjustment that allows fairness and accuracy across MA and APMs
Medicare Advantage	Prompt and Fair Pay Act (H.R. 4559)	Extends to in-network providers existing prompt payment and rate equity standards which currently govern MA plan payments for out-of-network providers	Reps. Lloyd Doggett (D-TX); Greg Murphy (R-NC) House Cosponsor List	Support
Medicare Advantage	Apples to Apples Comparison Act (H.R. 4093)	Aims to improve the transparency of Medicare costs for consumers by requiring CMS to publish detailed cost comparison reports between MA and FFS options.	Reps. Aaron Bean (R-FL); Kevin Hern (R-OK) House Cosponsor List	Neutral
Skin Substitutes	Skin Substitute Access and Payment Reform Act (S. 2561)	Creates a new payment limit for skin substitutes that is based on the volume-weighted average ASP payment limit for skin substitute products in Q4 of 2023 The new payment limit would be determined by multiplying: (A) the ASP payment limit in the Q4 of 2023 for each skin substitute billing code by (B) the total number of units billed for that skin substitute billing code in Q4 of 2023, to arrive at total spending for that billing code in Q4 of 2023 Requires CMS to add up all of the spending on each billing code (as determined in the first step). Finally, to arrive at the new payment limit for skin substitutes, CMS would then divide the sum of all spending (as determined in the second step) by the total number of units billed (across all billing codes in Q4 2023)	Sen. Bill Cassidy (R-LA) Senate Cosponsor List	*Neutral* *(Support in Concept)* Better than status quo but payments would be substantially higher than payment limits included in the CY 2026 MPFS proposed rule

**For more information on the status of bills, or information on how to contact your Members of Congress, please contact [email protected].

118th Congress

118^th Congress Lame Duck End-of-Year Health Legislation Section-by-Section (12/24)
House Lawmakers Send Letter on CMMI Transparency (11/24)
House Lawmakers Send Letter to CMS on Digital Quality (10/24)
Bipartisan Group of House Lawmakers Send Letter to CMS on Accountable Care (07/24)
Statement: Senate Finance Hearing on Bolstering Chronic Care Through Medicare Physician Payment (04/24)
Member Alert: Lawmakers Introduce Bills on ACO Assignment & Medicaid Duals (03/24)
Statement: Senate Budget Hearing on How Primary Care Improves Health Care Efficiency (03/24)
House Lawmakers Send Letter Calling for Medicare Payment Reforms
NAACOS submits statement in response to House committee hearing on APMs and provider issues (10/23)
NAACOS coordinates letter with over 600 stakeholders calling for extension of APM incentives (10/23)
NAACOS submits recommendations to the House Budget Committee’s Health Care Task Force (10/23)
NAACOS submits recommendations to the House Committee on Ways and Means on how to improve access to accountable care in rural and underserved communities (10/23)
NAACOS leads stakeholder Letter supporting introduction of Value in Health Care Act (07/23)
NAACOS testifies before House committee on MACRA oversight (06/23)
House Lawmakers Send Letter Calling for Medicare Payment Reforms (06/23)
NAACOS submits a statement for the record in response to a Senate Finance Health Subcommittee hearing on rural health access (05/23)
NAACOS submits a statement for the record in response to a House Ways and Means Health Subcommittee hearing on examining policies that inhibit innovation and patient access (05/23)
NAACOS Supports Reintroduction of Chronic Care Management Improvement Act of 2023 (04/23)
NAACOS and 11 other organizations send letter to Congress outlining recommendations to promote value-based patient care in Medicare (02/23)

117^th Congress

Lawmakers Send Letter to House Leaders Supporting Advanced APM Extension
NAACOS and co-host Capitol Hill Briefing “Speeding the Transition to Value-Based Care” on extending MACRA’s 5 percent incentive payment
NAACOS summary of the June 2022 MedPAC
Lawmakers Send Letters Asking Biden Administration to Support ACOs and Direct Contracting
NAACOS submits a Statement for the Record on a House Ways and Means Committee hearing on improving health equity for individuals with chronic conditions
NAACOS and seven other health groups ask Congress to support alternative payment models as a means to help prolong the solvency of the Medicare trust fund
NAACOS resource on Medicare payment updates under MACRA
NAACOS supports bill that revises MSSP assignment to enhance the role of NPPs
NAACOS submits comments in response to the Congressional Social Determinants of Health (SDOH) Caucus request for information (RFI) on challenges and opportunities to better address SDOH
NAACOS submits comments in response to congressional request for information (RFI) on public option legislation
NAACOS supports bill that removes cost-sharing obligations from Medicare Chronic Care Management codes
NAACOS and 13 other leading organizations support the Value in Health Care Act of 2021
- Section-by-section summary and press release
- Independent analysis shows Value Act would save $280 million over 10 years
NAACOS summary of the June 2021 MedPAC report
NAACOS and 12 others write Congress in support of the Accountable Care In Rural America Act (H.R. 3746)
- One-page summary of the “Rural Glitch” issue and press release on the letter
NAACOS submits a Statement for the Record on a House Ways and Means Committee hearing on the future of telehealth
NAACOS submits a Statement for the Record on the nominations of Andrea Palm to be Deputy HHS Secretary and Chiquita Brooks-LaSure to be CMS Administrator
Rhode Island Sen. Sheldon Whitehouse touts ACOs during Secretary Becerra’s confirmation hearing
ACOs receive praise during Senate confirmation hearing

Heard on the Hill

Overview

119th Congress: Legislative Tracker

Topic

Bill & Status

Summary

Sponsors

Positions

eCQM

APM Incentives

Medicare Extenders

Physician Payment

Physician Payment

Budget Reconciliation

118th Congress

117th Congress

NAACOS

INFORMATION

119^th Congress: Legislative Tracker

117^th Congress