Sponsors (4)
The bill reduces out-of-pocket costs and likely increases use of chronic care management for Medicare beneficiaries with chronic conditions, improving access and potentially outcomes, but it raises Medicare spending and creates fiscal and cost‑containment risks from higher utilization and provider charges.
Medicare beneficiaries with chronic conditions will no longer owe deductibles or coinsurance for chronic care management services beginning Jan 1, 2027, reducing their out-of-pocket costs for routine chronic care.
Patients with chronic conditions (many seniors and retirees) may use chronic care management more often because cost barriers are removed, which could improve ongoing disease management and health outcomes.
Providers (hospitals, health systems, clinicians) will receive full payment for chronic care management (100% of allowable or actual charge), improving reimbursement predictability for furnishing these services.
Taxpayers and Medicare beneficiaries face higher Medicare spending because eliminating cost-sharing increases program outlays and could put upward pressure on premiums or require greater federal spending.
The combination of higher reimbursement and no patient cost-sharing could increase utilization of billed chronic care management services, raising program costs without guaranteed proportional improvements in health outcomes.
If payment is tied to actual charges up to a fee schedule ceiling, providers may bill higher actual charges up to that ceiling, which could complicate cost containment and further increase costs for the Medicare program.
Based on analysis of 2 sections of legislative text.
Eliminates Medicare Part B coinsurance and the Part B deductible for chronic care management services and requires Medicare to pay 100% of the lesser of charge or fee-schedule amount, effective Jan 1, 2027.
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 furnished on or after January 1, 2027. It also requires Medicare to pay 100% of the lesser of the actual charge or the applicable physician fee-schedule amount for those chronic care management services, removing the usual beneficiary coinsurance. The change applies to chronic care management services defined in current Medicare law and takes effect for services furnished on or after January 1, 2027. The measure changes payment and beneficiary liability rules but does not appropriate new discretionary funds or create a new program structure.