This bill extends many health programs and makes changes to how care is delivered and paid for. It aims to help people find in-network doctors, keep Medicaid rolls accurate, expand access to care in communities, and strengthen responses to addiction and public health emergencies. It also pushes more transparency in drug and insurance practices and updates rules for telehealth and hospital care at home. The overall goal is to make care easier to access, clearer to navigate, and safer for patients and families .

Key changes that matter day to day include:

• Help finding in-network care: Medicare Advantage plans must protect patients from surprise costs if a plan’s provider directory is wrong, and plans will have to measure and post directory accuracy scores (starting in 2027–2028) so people can see which plans keep their doctor lists up to date .
• Keeping Medicaid accurate: States must check quarterly to remove people who have died from Medicaid and quickly fix any mistakes, starting in 2026. This helps make sure benefits go to those who are eligible and stops billing after a death .
• Telehealth and at-home care: Medicare will add claim modifiers to track certain telehealth setups by 2026, and the “hospital care at home” waiver is extended through 2029, with studies on safety and quality. This supports care at home while watching results closely .
• Community care funding: Funding is extended for community health centers, the National Health Service Corps, and teaching health centers, helping keep clinics open, clinicians in shortage areas, and training pipelines strong into 2026 and beyond .
• Addiction and overdose response: Parts of the national opioid response are renewed, including prevention, treatment, workforce, and grants, and the temporary order covering fentanyl-like substances is extended to September 30, 2026 .
• Drug and insurance transparency: New reporting and information-sharing rules increase insight into pharmacy benefit practices for employer health plans, aiming to shed light on costs and contracts that affect premiums and out-of-pocket costs .
• Hospital outpatient sites: Each off-campus hospital clinic will need its own unique identifier and a compliance attestation for Medicare payment starting in 2026, helping patients and Medicare see where care is actually delivered and billed .

Who is affected and when:

• Patients in Medicare Advantage: directory protections start in 2027; accuracy scores posted starting in 2028 .
• Medicaid enrollees and families: deceased-enrollee checks begin January 1, 2026; reinstatement required if a mistake happens .
• People using telehealth or hospital-at-home: new telehealth claim tracking by 2026; hospital-at-home flexibilities through 2029 .
• Communities: extended funding supports local clinics and health workers in 2025–2029, improving access, especially in underserved areas .
• Employers and workers with job-based coverage: more transparency into pharmacy benefit practices over the next few years .