Sponsors (45)
Official title: To amend titles XVIII and XIX of the Social Security Act to provide for coverage of peripheral artery disease screening tests furnished to at-risk beneficiaries under the Medicare and Medicaid programs without the imposition of cost-sharing requirements, and for other purposes.
Introduced January 9, 2025 by LaMonica McIver · Last progress January 9, 2025
The bill expands and standardizes PAD screening and prevention services to detect disease earlier and reduce amputations—especially for Medicare/Medicaid and high‑risk patients—but does so at increased federal/state cost, added administrative burden, and risk of uneven implementation or limited access in underserved areas.
Medicare, Medicaid and other at‑risk patients (people with PAD, diabetes, seniors) will get earlier and more routine PAD screening and diagnostic testing, increasing early detection and likely reducing avoidable amputations, cardiac events, disability, and mortality.
Low‑income, Medicare and Medicaid beneficiaries will face lower out‑of‑pocket costs for PAD screening (no Part B deductible, no Medicaid cost‑sharing), making preventive care more affordable.
Underserved and high‑risk communities (rural areas, racial/ethnic minorities, Medicare/Medicaid populations) are explicitly targeted for outreach and education, which could reduce disparities in limb loss and PAD outcomes if implemented equitably.
Taxpayers, Medicare trust funds, and state budgets will face increased near‑term and ongoing costs from expanded screening coverage, $6 million/year authorized program spending, and higher Medicaid utilization.
If follow‑through treatment, access to specialty vascular care, and equitable implementation are not ensured, minority, rural, and low‑income patients may continue to experience disparities — or see screening without access to definitive care.
New programs, payment changes, and quality measures will impose administrative, reporting, and operational burdens on federal and state agencies, hospitals, and clinicians and could duplicate existing efforts if not well coordinated.
Based on analysis of 6 sections of legislative text.
Funds PAD education; requires Medicare/Medicaid coverage and no cost‑sharing for PAD screening for defined at‑risk groups; mandates quality measures and CMMI testing.
Creates a coordinated federal effort to reduce avoidable lower‑limb amputations by expanding education, screening coverage, quality measurement, and payment model testing for peripheral artery disease (PAD). It funds a CDC PAD education program, requires Medicare and Medicaid coverage with no cost‑sharing for defined at‑risk screening tests, directs HHS to develop quality measures tied to amputation prevention, and tasks CMMI with testing a voluntary amputation‑prevention payment and delivery model. Most coverage changes take effect January 1, 2026; the bill authorizes CDC education funding for FY2026–FY2030 and requires HHS to implement quality measures and a CMMI model within 18 months of enactment.