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Adds prescription digital therapeutics to Medicare Part B and to the list of items covered under Medicaid beginning January 1, 2026. Requires the Department of Health and Human Services to create a new Medicare payment framework with coding, payment rules, manufacturer reporting, confidentiality protections, and penalties, with specific deadlines for a payment methodology and product-specific codes.
Establishes manufacturer reporting obligations starting January 1, 2026, and gives CMS 1 year to set an initial payment methodology and 2 years to issue HCPCS codes for individual products; Medicaid coverage is updated to reference the new statutory definition of prescription digital therapeutics.
Read twice and referred to the Committee on Finance.
Introduced May 8, 2025 by Shelley Moore Capito · Last progress 10 months ago