ARC Act of 2025

Bill Number

H.R. 307

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-01-14: Sponsor introductory remarks on measure. (CR H122)

Last Updated

2026-04-28T08:05:46Z

AI-Generated Summary

Purpose of the Legislation

The Amputation Reduction and Compassion Act of 2025 (ARC Act of 2025) aims to reduce amputations and related health risks by increasing awareness, screening, and treatment for peripheral artery disease (PAD). PAD is a condition where arteries in the legs narrow or block due to fatty deposits (atherosclerosis), raising risks for heart attacks, strokes, amputations, and death. The bill emphasizes early detection, especially for at-risk groups like older adults, people with diabetes, and minorities who face higher amputation rates. It promotes cost-effective screening as part of routine care and seeks to lower healthcare costs and mortality through education, coverage expansions, quality measures, and pilot programs.

Key Provisions

• Findings and Short Title: Outlines 11 congressional findings on PAD's prevalence (affecting ~21 million Americans), its links to atherosclerosis, disproportionate impacts on minorities (e.g., African Americans with diabetes face up to 4x higher amputation risks), and benefits of screening (e.g., 67% higher cardiac death risk without detection). Cites the act as the "ARC Act of 2025."

• PAD Education Program: Adds a new section to the Public Health Service Act requiring the Secretary of Health and Human Services (HHS), through the Centers for Disease Control and Prevention (CDC), to collaborate with the Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA), clinical organizations, and patient advocates. The program will develop outreach to educate healthcare professionals and the public on PAD risks, prevention, and amputation reduction, focusing on at-risk populations. Authorizes $6 million annually from fiscal years 2026–2030 for best practices dissemination.

• Medicare Coverage for PAD Screening (effective January 1, 2026):
• Defines "PAD screening tests" as noninvasive ankle-brachial index testing, arterial duplex scans of leg arteries, and other Secretary-approved services.
• Defines "at-risk beneficiaries" as Medicare enrollees aged 65+, those 50–64 with atherosclerosis risks (e.g., diabetes, smoking history, high cholesterol, high blood pressure) or family history, those under 50 with diabetes plus another risk, or those with known artery disease elsewhere (e.g., heart, neck, or abdominal arteries).
• Adds these screenings to covered preventive services under Medicare Part B, including the initial "Welcome to Medicare" physical exam.
• Requires the Secretary to set frequency standards in consultation with stakeholders.
• Eliminates deductibles, coinsurance, and other cost-sharing (patients pay nothing); pays 100% of the lesser of actual charges or the physician fee schedule rate.
• Excludes coverage if tests exceed approved frequency; protects against Medicare as secondary payer in such cases.
• Bars the Secretary from modifying or eliminating this coverage without congressional approval.
• Applies to hospital outpatient services outside bundled payments.

• Medicaid Coverage for PAD Screening:
• Mirrors Medicare definitions for tests and at-risk individuals (adapted for Medicaid enrollees under state plans or waivers).
• Adds screenings as a mandatory covered service without cost-sharing (no copays or premiums).
• Requires frequency standards; includes conforming updates to state plan rules.

• Quality Measures Development: Directs the HHS Secretary to create measures for nontraumatic lower-limb major amputations, emphasizing PAD screening and alternatives like revascularization (restoring blood flow via procedures). Within 18 months of enactment, these measures must be tested, validated, and integrated into Medicare quality reporting, including:
• Merit-based incentive payments for physicians.
• Alternative payment models.
• Accountable Care Organizations (shared savings programs).
• Innovation Center models.
• Other payment systems.

• Amputation Prevention Pilot Program: Adds to CMS's Center for Medicare and Medicaid Innovation (CMMI) a voluntary model for hospitals, ambulatory surgical centers, and office-based practices. Focuses on high-risk patients through risk factor management, early PAD screening/surveillance, testing/treatment, and care coordination to cut amputation rates and costs. Testing must begin within 18 months of enactment.

Significant Changes to Existing Law

• Expansions to Social Security Act (Titles XVIII and XIX): Introduces PAD screening as a new preventive benefit under Medicare (Part B) and Medicaid, previously not explicitly covered without cost-sharing. Integrates into existing preventive exams and payment systems (e.g., physician fee schedule, hospital outpatient prospective payment system exclusions).
• Public Health Service Act Addition: Creates a dedicated federal education program for PAD, building on but separate from general chronic disease initiatives.
• Quality and Innovation Updates: Mandates new amputation-focused quality metrics in Medicare programs (e.g., under the Merit-based Incentive Payment System and CMMI), shifting emphasis from treatment to prevention. Limits Secretary's authority to alter certain preventive services.
• Cost-Sharing Eliminations: Removes financial barriers for these screenings, aligning with other no-cost preventive services (e.g., mammograms, colonoscopies) but specifically targeting PAD to address gaps in vascular care guidelines.
• Frequency and Exclusion Rules: Establishes standards to prevent overuse, amending exclusions for non-medical necessity services.

Potential Impacts

• On Citizens: Improves access to free PAD screenings for ~21 million at-risk individuals, potentially preventing 200,000+ annual amputations (disproportionately affecting minorities) and reducing related deaths (e.g., 33–52% die within 2 years post-amputation). Enables earlier cardiac risk management, lowering heart attack/stroke rates. May increase routine check-ups, especially for underserved groups like African Americans, Native Americans, and Hispanics.

• On Government Agencies: Increases responsibilities for HHS/CMS (coverage administration, payment processing, frequency standards), CDC (education/outreach), and HRSA (collaboration). Authorizes $30 million total for education; pilot and quality measures could generate long-term savings via fewer costly amputations/hospitalizations, though initial implementation costs rise. States must update Medicaid plans without federal matching penalties for compliance.

• On International Relations: No direct impacts; focuses on domestic U.S. health policy.

Main Stakeholders Affected

• At-Risk Beneficiaries: Medicare/Medicaid enrollees meeting criteria (e.g., seniors, diabetics, smokers, those with family history or vascular issues), particularly racial/ethnic minorities facing higher risks.
• Healthcare Providers and Facilities: Physicians, hospitals, surgical centers, and vascular specialists who perform screenings/treatments; benefit from quality incentives and pilot funding but face new reporting requirements.
• Patient Advocacy and Clinical Organizations: Groups for diabetes, heart disease, and amputees; involved in consultations, education, and guideline development.
• Government Entities: HHS, CMS, CDC, HRSA, and state Medicaid agencies; handle implementation, funding, and oversight.
• Taxpayers and Insurers: Potential short-term federal spending increases offset by preventive savings; private insurers may see indirect effects via coordinated care.

Notable Legal, Constitutional, or Political Implications

• Legal: Amends core entitlement programs (Medicare/Medicaid) to expand preventive benefits, potentially setting precedent for covering emerging vascular screenings. Includes safeguards against arbitrary coverage changes (e.g., congressional override for modifications) and overuse exclusions to ensure fiscal responsibility under existing non-discrimination rules.
• Constitutional: No apparent challenges; aligns with Congress's spending power under Article I and general welfare clause, promoting public health without infringing on states' rights (Medicaid expansions are optional but incentivized).
• Political: Addresses health disparities in minority communities, supporting equity goals in preventive care. Could influence broader debates on chronic disease funding and CMMI's role in value-based care, with bipartisan appeal via cost savings (e.g., reducing $200,000+ annual amputation expenses) but potential contention over new mandates and appropriations.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. McIver, LaMonica [D-NJ-10]

Cosponsors (44)

Rep. Jackson, Jonathan L. [D-IL-1], Rep. Kelly, Robin L. [D-IL-2], Rep. Watson Coleman, Bonnie [D-NJ-12], Rep. Sewell, Terri A. [D-AL-7], Rep. Davids, Sharice [D-KS-3], Rep. Johnson, Henry C. "Hank" [D-GA-4], Rep. McCollum, Betty [D-MN-4], Rep. Takano, Mark [D-CA-39], Rep. Brownley, Julia [D-CA-26], Rep. Meeks, Gregory W. [D-NY-5], Rep. Davis, Donald G. [D-NC-1], Rep. Sykes, Emilia Strong [D-OH-13], Rep. Thompson, Bennie G. [D-MS-2], Del. Norton, Eleanor Holmes [D-DC], Rep. Castro, Joaquin [D-TX-20], Rep. Clarke, Yvette D. [D-NY-9], Rep. Lee, Summer L. [D-PA-12], Rep. Davis, Danny K. [D-IL-7], Rep. Trahan, Lori [D-MA-3], Rep. Beatty, Joyce [D-OH-3], Rep. Grijalva, Raúl M. [D-AZ-7], Rep. Doggett, Lloyd [D-TX-37], Rep. Bergman, Jack [R-MI-1], Rep. Stanton, Greg [D-AZ-4], Rep. Cherfilus-McCormick, Sheila [D-FL-20], Rep. Carson, André [D-IN-7], Rep. Craig, Angie [D-MN-2], Rep. Wilson, Frederica S. [D-FL-24], Rep. Bishop, Sanford D. [D-GA-2], Rep. Kean, Thomas H. [R-NJ-7], Del. Moylan, James C. [R-GU-At Large], Rep. Mfume, Kweisi [D-MD-7], Rep. Wasserman Schultz, Debbie [D-FL-25], Rep. Johnson, Julie [D-TX-32], Rep. Waters, Maxine [D-CA-43], Rep. Frost, Maxwell [D-FL-10], Rep. Velázquez, Nydia M. [D-NY-7], Rep. Foushee, Valerie P. [D-NC-4], Rep. Gottheimer, Josh [D-NJ-5], Rep. Thanedar, Shri [D-MI-13], Rep. Veasey, Marc A. [D-TX-33], Del. Plaskett, Stacey E. [D-VI-At Large], Rep. Ross, Deborah K. [D-NC-2], Rep. Soto, Darren [D-FL-9]

Recent Actions

• 2025-01-14: Sponsor introductory remarks on measure. (CR H122)
• 2025-01-09: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-01-09: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-01-09: Introduced in House
• 2025-01-09: Introduced in House

Bill Versions

• Amputation Reduction and Compassion Act of 2025 — issued 2025-01-09 — PDF (18 pages)