S. 1105 · 119th Congress
No UPCODE Act
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R
CassidySponsor1 cosponsor · 1 D
1 signed on when it was introduced; the rest joined later. Cosponsors who withdrew aren't shown.
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act
What it does: CRS summary · Introduced in Senate · Mar 25, 2025
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act
This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data.
Specifically, the bill requires the Centers for Medicare & Medicaid Services (CMS) to use two years of diagnostic data in its risk adjustment methodology for MA payments. It also prohibits the CMS from using diagnoses that are collected from chart reviews or health risk assessments when adjusting payments based on health status. The CMS must also take into account any differences in coding patterns between MA and traditional Medicare when determining MA payment adjustments.
Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov
About this bill and sources
Official title: No UPCODE Act
Also known as: No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act
Latest action (Mar 25, 2025): Read twice and referred to the Committee on Finance.
Policy area: Health · Origin: Senate · Introduced: Mar 25, 2025
Official page on Congress.gov · Bill text (GovInfo) · Status record (XML)
No recorded floor vote found.