Sponsors (2)
The bill expands Medicare patients' choice and clarifies administration by allowing advance contracting and a uniform national charge rule, but it risks higher costs for patients and taxpayers, limits state consumer protections, and excludes dual‑eligible beneficiaries from the new contracting option.
Medicare beneficiaries and eligible professionals can make advance private contracts where claims are processed 'as if' the provider were participating, increasing patient access to chosen providers and preserving provider participation for Medicare-covered services.
Medicare beneficiaries can require providers to submit Medicare and supplemental insurer claims and assign payments, reducing paperwork and out-of-pocket administrative burden for patients.
Contracts must be written, signed, specify payment terms, and hold beneficiaries harmless for charges above the contract, giving beneficiaries clearer consumer protections against surprise billing.
Patients, taxpayers, and insurers may face higher costs because contract services are exempted from certain payment‑limit rules and non‑participating providers can be treated 'as if participating,' and the bill limits states' ability to cap provider charges—potentially increasing out‑of‑pocket costs, Medicare spending, and premiums.
Dual‑eligible Medicare‑Medicaid beneficiaries are barred from using these contracts, denying low‑income and medically vulnerable people the same contracting flexibility and protections as other Medicare beneficiaries.
The legislation reduces State and local governments' flexibility to cap provider charges or use rate limits as tools to control healthcare spending and protect consumers in their jurisdictions.
Based on analysis of 3 sections of legislative text.
Permits written pre‑service private contracts between Medicare beneficiaries and eligible professionals and preempts State limits on charges for those contracted services.
Official title: Amend title XVIII of the Social Security Act to establish a Medicare payment option for patients and eligible professionals to freely contract, without penalty, for Medicare fee-for-service items and services, while allowing Medicare beneficiaries to use their Medicare benefits.
Introduced May 20, 2026 by Rand Paul · Last progress May 20, 2026
Allows Medicare beneficiaries to sign written, pre‑service private contracts with eligible professionals for Medicare‑covered items and services, treated for payment as if the provider were a participating Medicare provider, while preserving certain beneficiary protections and exclusions. The bill also invalidates State laws that cap or limit charges for such services when payment is made under the referenced Medicare payment provision, applying nationwide to the states and territories.