Sponsors (9)
The bill improves access to and provider payment for chronic care management for Medicare beneficiaries—likely reducing out-of-pocket costs and encouraging use—but increases Medicare spending and creates risks of higher utilization and upward billing pressure that could raise costs for taxpayers and the program.
Medicare beneficiaries with chronic conditions will pay no cost-sharing for chronic care management services starting Jan 1, 2027, lowering out-of-pocket costs for routine care.
Patients with chronic conditions (particularly seniors) are likely to use chronic care management services more when cost barriers are removed, which may improve ongoing disease management and health outcomes.
Providers (hospitals and other clinicians) will receive full payment for furnishing chronic care management services, increasing reimbursement predictability and potentially encouraging provision of these services.
Removing patient cost-sharing will increase Medicare program spending, which could lead to higher federal outlays or pressure to raise Medicare premiums or other taxpayer burdens.
Higher reimbursement combined with no cost-sharing could increase utilization of billed chronic care management services, raising program costs without guaranteed proportional improvements in health outcomes.
If payment is set to actual charges up to a fee-schedule ceiling, some providers may bill higher actual charges up to that ceiling, complicating cost containment and potentially increasing per-service costs.
Based on analysis of 2 sections of legislative text.
Removes Medicare Part B coinsurance and deductible for defined chronic care management services and requires Medicare to pay 100% of the lesser of charge or fee-schedule for those services beginning Jan 1, 2027.
Eliminates Medicare Part B cost-sharing and the Part B deductible for designated chronic care management services starting January 1, 2027, by requiring Medicare to pay 100% of the lesser of the actual charge or the fee-schedule amount for those services. The change applies to chronic care management services defined under current law and removes both coinsurance/copayment and deductible requirements for services furnished on or after that date.
Official title: To amend title XVIII of the Social Security Act to remove cost-sharing responsibilities for chronic care management services under the Medicare program.
Introduced April 14, 2026 by Suzan K. Delbene · Last progress April 14, 2026