No Medicare Clawbacks Act of 2026
- Bill Number
- H.R. 9532
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Status
- Introduced
- Latest Action
- 2026-06-29: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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
- 2026-07-06T13:38:28Z
AI-Generated Summary
Purpose
This legislation seeks to prevent group health plans from recovering (or "clawing back") payments they initially made for medical services in specific situations involving retroactive Medicare coverage.
Key Provisions
- Amends Medicare rules under the Social Security Act to add a prohibition: If a group health plan pays for an item or service for a Medicare-eligible person without initially considering their Medicare entitlement, it cannot later recover that payment if the service occurred during a retroactive Medicare Part A coverage period and the individual was not behind on required plan contributions.
- Extends existing enforcement rules to cover violations of this new prohibition.
Significant Changes to Existing Law
- Introduces an explicit ban on payment recoveries by group health plans in cases of retroactive Medicare entitlement, which expands prior coordination rules between Medicare and private plans.
- Modifies the Medicare secondary payer provisions to protect certain payments from later recoupment.
Potential Impacts
- On citizens: Medicare beneficiaries may avoid unexpected demands to repay group health plans for past services.
- On government agencies: The Centers for Medicare & Medicaid Services may see changes in how benefits are coordinated with private insurers, potentially affecting claims processing.
- No notable effects on international relations.
Main Stakeholders Affected
- Medicare beneficiaries who are also enrolled in employer-sponsored group health plans.
- Group health plans, including employers and insurers.
- Healthcare providers involved in billing for covered services.
Notable Legal, Constitutional, or Political Implications
- This represents a targeted update to federal Medicare payment coordination rules without altering broader constitutional authorities over health programs.
- It may influence legal disputes over payment recoveries but introduces no apparent new constitutional conflicts.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Torres, Ritchie [D-NY-15]
Cosponsors (1)
Rep. Clarke, Yvette D. [D-NY-9]
Recent Actions
- 2026-06-29: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
- 2026-06-29: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
- 2026-06-29: Introduced in House
- 2026-06-29: Introduced in House
Bill Versions
- No Medicare Clawbacks Act of 2026 — issued 2026-06-29 — PDF (3 pages)