Sponsors (8)
The bill improves access to coordinated ALS care and clinical trials for Medicare beneficiaries and supports providers with a bundled payment and planning requirements, but it increases federal spending and carries risks of underpayment, uneven access, and implementation delays that could shift costs or reduce care for some patients.
Medicare beneficiaries with ALS will gain Medicare coverage for a bundled set of ALS outpatient services starting Jan 1, 2027, lowering out-of-pocket costs and improving access to coordinated multidisciplinary care.
People with ALS and potential trial participants will likely see faster and better access to clinical trials because the bill increases trial funding/staffing support and reimburses providers for participating in NIH-listed trials.
Hospitals and clinicians gain more predictable payments (a single per-visit ALS payment starting at $800 and an ALS services market basket with periodic GAO reviews), which improves payment certainty and could encourage investment in multidisciplinary ALS care and technology.
Taxpayers and Medicare financing could face substantial increased federal spending because the bill raises ALS reimbursements, eliminates beneficiary cost sharing for bundled services, and may prompt additional appropriations for trials.
A fixed per-visit base payment (starting at $800) and reliance on supplemental OPD payments risk underpaying complex ALS visits, which could reduce provider willingness to offer comprehensive services and create uneven access across providers.
Targeted increases in ALS reimbursement and the elimination of beneficiary cost sharing could divert limited Medicare resources toward ALS care and away from other conditions if not funded separately, putting pressure on overall program sustainability.
Based on analysis of 4 sections of legislative text.
Requires Medicare coverage and an $800-per-visit payment (starting 2027) for defined ALS-related services, bans beneficiary cost sharing, sets indexing rules, and directs an NIH report on clinical trial challenges.
Introduced February 3, 2026 by Janice D. Schakowsky · Last progress February 3, 2026
Creates Medicare coverage and a new, single per-visit payment for a defined set of ALS-related services for people medically determined to have ALS, effective January 1, 2027. Sets a base payment of $800 per visit in 2027 (and at least $800 in 2028), specifies how payments are indexed in later years, prohibits beneficiary cost sharing for these visits, and establishes payment adjustments for clinical trial participation and new costly services/technologies. Directs the NIH (through NINDS) to publish and deliver to Congress a report within 90 days identifying challenges in ALS clinical trial administration and staffing, actions NIH can take to address them, and any legislative or funding recommendations to improve trial conduct and capacity.