Sponsors (13)
Introduced February 3, 2026 by Janice D. Schakowsky · Last progress February 3, 2026
The bill expands and stabilizes Medicare coverage and support for multidisciplinary ALS care and clinical trials—improving access and potentially accelerating treatments for people with ALS—but increases federal Medicare spending, shifts more costs onto the program (and taxpayers), may under- or mis-price complex care, and could leave some rural/low-income patients behind without additional infrastructure supports.
Medicare beneficiaries with ALS gain a new, statutory outpatient benefit (starting Jan 1, 2027) providing multidisciplinary ALS services and reducing out-of-pocket care gaps.
Patients with ALS (and participating providers) get stronger support for clinical trial participation—additional payment adjustments for trial costs and NINDS actions to address trial bottlenecks—improving access to investigational therapies and speeding trials.
ALS patients in rural and remote areas would have improved access through expanded telehealth coverage, reducing travel burdens and enabling more timely care.
Taxpayers and Medicare program finances face higher federal spending because expanding Medicare benefits and increasing reimbursements will raise program costs.
Medicare beneficiaries lose patient cost sharing for these ALS outpatient services, shifting all costs to Medicare and increasing utilization and fiscal pressure on the program.
The $800 single-visit base payment may be insufficient for complex ALS multidisciplinary visits, leaving providers undercompensated if actual costs exceed the payment.
Based on analysis of 4 sections of legislative text.
Adds a new Medicare outpatient benefit and annual single payment for defined ALS-related services, effective Jan 1, 2027, with a statutory payment formula and GAO review.
Creates a new Medicare outpatient benefit that pays for a defined set of ALS-related services delivered by qualified providers, starting January 1, 2027. The law defines covered services (specialized physician or NP support, PT/OT, speech pathology, dietary and respiratory support, registered nursing, durable medical equipment coordination, and telehealth) and establishes a single annual base payment per ALS patient with a statutory formula for future adjustments and periodic Comptroller General review. Directs HHS/NIH (through NINDS) to report to Congress within 90 days after enactment on challenges staffing and running ALS clinical trials and to recommend actions and any legislative or funding needs to improve trial administration and capacity.