No UPCODE Act
- Bill Number
- S. 1105
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-03-25: Read twice and referred to the Committee on Finance.
- Last Updated
- 2025-12-11T15:04:06Z
Official Summary
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.
Sponsor
Cosponsors (1)
Recent Actions
- 2025-03-25: Read twice and referred to the Committee on Finance.
- 2025-03-25: Introduced in Senate
Bill Versions
- No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act — issued 2025-03-25 — PDF (4 pages)