Sponsors (7)
Introduced January 28, 2025 by Darin Lahood · Last progress January 28, 2025
The bill extends APM eligibility and clarifies statutory references through 2027 to preserve care coordination and payment stability for Medicare and providers, while imposing continued federal cost, potential delays to planned APM reforms, and modest administrative updates.
Medicare beneficiaries will continue to potentially receive improved care coordination if clinicians remain in alternative payment models (APMs) through 2027.
Hospitals, health systems, and other providers keep eligibility for APM incentive payments for an additional year, preserving payment continuity into 2027.
Centers for Medicare & Medicaid Services (CMS) and program participants face reduced regulatory uncertainty because cross-references and headings are aligned across statutes.
Taxpayers will continue to bear federal spending implicit in extending Medicare APM incentive payments for 2027 (amounts not newly specified).
CMS and providers could see planned policy changes tied to the 2026 cutoff postponed, delaying APM design or oversight reforms until 2027.
CMS, hospitals/health systems, and healthcare workers will face administrative burden to update documentation and compliance processes to reflect the new statutory references.
Based on analysis of 2 sections of legislative text.
Extends the calendar-year references in Medicare incentive-payment rules so that incentive payments for participation in eligible alternative payment models (APMs) continue through 2027 instead of ending in 2026. It updates statutory cross-references in Medicare payment law to reflect the new year but does not create new programs or change payment amounts. The change preserves APM incentive eligibility for clinicians and organizations for an additional year and requires only statutory text updates to the Social Security Act and related Medicare payment cross-references.