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The bill eliminates cost-sharing for chronic care management so Medicare patients pay less and may get better ongoing care, but it increases Medicare spending and raises risks of higher utilization and billing that could drive costs for taxpayers and the program.
Medicare beneficiaries with chronic conditions will no longer owe deductibles or coinsurance for chronic care management services starting Jan 1, 2027, reducing their out-of-pocket costs for routine chronic care.
Patients with chronic conditions (especially 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 and health systems furnishing chronic care management will receive full payment (100% of allowable or actual charge), improving reimbursement predictability and financial stability for those services.
Taxpayers and Medicare beneficiaries could face higher overall Medicare spending (and potential pressure for higher premiums or greater federal outlays) because cost-sharing is eliminated.
Removing patient cost-sharing and increasing reimbursement may encourage higher utilization of billed chronic care management services without guaranteed proportional health benefits, driving program costs up.
If providers can bill up to actual charges (subject to fee schedule ceilings), there is a risk providers will bill higher actual charges up to that ceiling, complicating cost containment and increasing per-service costs.
Based on analysis of 2 sections of legislative text.
Removes Part B deductible and coinsurance for qualifying chronic care management services and requires Medicare to pay 100% of the lesser of charge or fee-schedule amount, effective Jan 1, 2027.
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
Eliminates Medicare Part B cost-sharing and the Part B deductible for chronic care management services provided on or after January 1, 2027. The law requires Medicare to pay 100% of the lesser of the actual charge or the applicable fee schedule amount for those chronic care management services, removing patient coinsurance and deductible liability for those services.