Chronic Care Management Improvement Act of 2026
- Bill Number
- H.R. 8261
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-04-14: 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.
- Last Updated
- 2026-07-01T08:08:50Z
AI-Generated Summary
Purpose
The Chronic Care Management Improvement Act of 2026 (H.R. 8261) aims to eliminate patient cost-sharing requirements—such as coinsurance and deductibles—for chronic care management (CCM) services provided under Medicare Part B, starting January 1, 2027. CCM services involve ongoing coordination of care for patients with multiple chronic conditions.
Key Provisions
- Full Medicare Payment for CCM Services: Medicare will pay 100% of the lesser of the provider's actual charge or the fee schedule amount under section 1848 of the Social Security Act for CCM services furnished on or after January 1, 2027.
- Deductible Exemption: The Part B annual deductible will not apply to these CCM services.
- Effective date: January 1, 2027.
Significant Changes to Existing Law
- Amends section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l) by adding a new subparagraph (II) to eliminate coinsurance.
- Amends section 1833(b) by adding a new paragraph (14) to exempt CCM services from the Part B deductible.
- Previously, Medicare Part B required beneficiaries to pay 20% coinsurance after meeting the deductible for CCM services.
Potential Impacts
- On Citizens (Medicare Beneficiaries): Reduces out-of-pocket costs for managing chronic conditions, potentially improving access to care and health outcomes for the 60+ million Medicare enrollees, many of whom have chronic illnesses.
- On Government Agencies: Increases costs to the Centers for Medicare & Medicaid Services (CMS) and the Medicare program due to full federal coverage without patient sharing; no direct impact on international relations.
- On Providers: Encourages more widespread offering of CCM services by ensuring full reimbursement.
Main Stakeholders Affected
- Medicare Beneficiaries: Especially those with two or more chronic conditions requiring ongoing management.
- Healthcare Providers: Physicians and practices billing for CCM services under Medicare Part B.
- CMS and Federal Budget: Responsible for administering payments and absorbing higher program expenditures.
Notable Legal, Constitutional, or Political Implications
- Legal: Straightforward amendment to Medicare payment rules; relies on Congress's authority under the Social Security Act to adjust benefits and payments.
- Constitutional: No apparent challenges; aligns with spending power for social welfare programs.
- Political: Could face debate over added Medicare costs amid fiscal concerns, but supports bipartisan interest in chronic disease management for an aging population. Referred to House Committees on Energy and Commerce and Ways and Means for review.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. DelBene, Suzan K. [D-WA-1]
Cosponsors (7)
Rep. Kelly, Mike [R-PA-16], Rep. Davis, Donald G. [D-NC-1], Rep. Sánchez, Linda T. [D-CA-38], Rep. Bynum, Janelle S. [D-OR-5], Rep. Sorensen, Eric [D-IL-17], Rep. Veasey, Marc A. [D-TX-33], Rep. Suozzi, Thomas R. [D-NY-3]
Recent Actions
- 2026-04-14: 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.
- 2026-04-14: 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.
- 2026-04-14: Introduced in House
- 2026-04-14: Introduced in House
Bill Versions
- Chronic Care Management Improvement Act of 2026 — issued 2026-04-14 — PDF (3 pages)