Sponsors (14)
The bill substantially expands and stabilizes Medicare coverage and payments to improve access to coordinated ALS care and speed research, but does so at increased federal cost and with risks of implementation delays, provider payment shortfalls, and unequal access for underserved populations.
Medicare beneficiaries with ALS gain a new covered outpatient multidisciplinary benefit (coordinated PT/OT/speech/respiratory/nutrition/RN/durable equipment) that reduces out-of-pocket costs and improves care coordination and clinical outcomes.
Providers and trial sites are incentivized to participate in ALS clinical research through payment adjustments and NINDS actions to identify and fix trial bottlenecks, which should speed trials and expand patient access to investigational therapies.
Expanded telehealth options improve access to multidisciplinary ALS care for patients in rural and remote areas, reducing travel burdens and enabling timelier care.
Expanding Medicare benefits and payments will raise federal Medicare spending and could require offsets (higher taxes, premiums, or cuts elsewhere), increasing fiscal pressure on taxpayers and the program.
Eliminating patient cost sharing for the ALS outpatient benefit shifts costs fully to Medicare, reducing beneficiary cost-control incentives and raising utilization and program costs borne by taxpayers.
Greater reliance on telehealth may worsen access for people without reliable broadband, devices, or digital literacy—particularly low-income and some rural patients—creating inequities in care.
Based on analysis of 4 sections of legislative text.
Adds a new Medicare outpatient benefit and single-visit payment for defined multidisciplinary ALS-related services, effective Jan 1, 2027, with periodic payment reviews.
Official title: To amend title XVIII of the Social Security Act to provide coverage of ALS-related services under the Medicare program for individuals diagnosed with amyotrophic lateral sclerosis, and for other purposes.
Introduced February 3, 2026 by Janice D. Schakowsky · Last progress February 3, 2026
Creates a new Medicare outpatient benefit covering a defined package of multidisciplinary "ALS-related services" for people medically diagnosed with amyotrophic lateral sclerosis (ALS), payable as a single-visit payment beginning January 1, 2027. Sets a statutory payment formula with a base amount and periodic adjustments tied to a market-basket percentage and Comptroller General recommendations, and requires a GAO-style report on recommended payment amounts every three years. Requires NIH/NINDS to report to Congress within 90 days on clinical-trial administration and staffing challenges and recommend actions, including any legislative or appropriations requests.