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 coverage—likely reducing amputations and improving equity for at‑risk patients—but it raises federal and state costs, increases demand on vascular services, and requires careful implementation and adequate funding to avoid administrative burdens, low‑value testing, and persistent disparities.
People with PAD and related chronic conditions (including seniors and people with diabetes) will be more likely to be identified earlier through expanded screening, testing, and surveillance, reducing avoidable amputations, cardiac events, and disability.
Medicare and Medicaid beneficiaries (and other low-income patients) will face lower out-of-pocket costs for PAD screening because screenings are covered without cost‑sharing or Part B deductible, improving access to preventive care.
Hospitals, clinics, and clinicians will face stronger quality incentives and payment support that encourage limb‑salvage practices and investment in diagnostic and vascular capacity, which can improve outcomes and long‑term cost savings.
Federal taxpayers, the Medicare trust fund, and state budgets will face increased short‑ and medium‑term costs from expanded screening coverage, program funding, and potential new payment models.
Expanded screening will increase demand for specialty vascular services and diagnostic capacity, risking longer wait times and access constraints—especially in rural and underserved areas where workforce and facilities are limited.
Hospitals, clinicians, state Medicaid agencies, and federal programs will incur new administrative, reporting, and operational burdens (and possible duplication with existing CDC/HRSA/CMS efforts) that raise short‑term costs and complexity.
Based on analysis of 6 sections of legislative text.
Funds CDC education, requires Medicare/Medicaid coverage and no cost‑sharing for PAD screening for at‑risk groups, adds quality measures, and directs CMMI to test prevention models.
Creates a coordinated federal effort to reduce avoidable lower‑limb amputations from peripheral artery disease (PAD) by funding CDC education and outreach, requiring Medicare and Medicaid coverage and no cost‑sharing for PAD screening for defined at‑risk groups, adding quality measures to discourage nontraumatic major amputations, and directing CMMI to test a voluntary prevention/payment model. Key deadlines include coverage effective Jan 1, 2026, and 18‑month timelines for quality‑measure and model testing.