Portable Ultrasound Reimbursement Equity Act of 2025
- Bill Number
- S. 1168
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-03-27: Read twice and referred to the Committee on Finance.
- Last Updated
- 2026-05-12T20:06:35Z
AI-Generated Summary
Purpose
The Portable Ultrasound Reimbursement Equity Act of 2025 aims to expand Medicare coverage to include transportation and setup services for portable ultrasound equipment. This ensures that these services are reimbursed similarly to existing portable X-ray services, promoting fair access to diagnostic imaging in non-hospital settings like homes or remote locations.
Key Provisions
- Expansion of Covered Services: Amends Section 1861(s)(3) of the Social Security Act to include "diagnostic X-ray and ultrasound tests" under Medicare Part B, broadening the scope of reimbursable diagnostic services.
- Separate Payment for Transportation and Setup: Adds a new subsection (aa) to Section 1834 of the Social Security Act, requiring the Secretary of Health and Human Services to provide distinct payments for portable ultrasound transportation and setup services. These payments must mirror those for portable X-ray services in terms of amount and process.
- Supplier Requirements: Establishes rules for suppliers of portable ultrasound services, which must be similar to those for portable X-ray suppliers (outlined in federal regulations under 42 CFR Part 486, Subpart C). This includes standards for equipment, personnel, and operations to ensure quality and safety.
- Effective Date: Applies to services provided on or after January 1, 2027.
Significant Changes to Existing Law
- Previously, Medicare covered transportation and setup only for portable X-ray services under diagnostic testing. This bill extends that coverage to portable ultrasounds, creating parity in reimbursement.
- Introduces specific regulatory alignment for ultrasound suppliers, adapting X-ray standards without creating entirely new frameworks, to streamline implementation.
Potential Impacts
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) will need to update payment systems, develop guidelines, and oversee compliance, potentially increasing administrative workload and costs initially.
- On Citizens: Medicare beneficiaries, particularly those in rural, homebound, or underserved areas, may gain better access to non-invasive ultrasound diagnostics (e.g., for pregnancy monitoring or vascular checks) without needing hospital transport, improving convenience and reducing out-of-pocket expenses.
- On International Relations: No direct impact, as this is a domestic healthcare policy focused on U.S. Medicare.
Main Stakeholders Affected
- Medicare Beneficiaries: Elderly and disabled individuals relying on Medicare for diagnostic services.
- Healthcare Providers and Suppliers: Companies and technicians providing portable ultrasound services, who will benefit from new reimbursement opportunities.
- Hospitals and Clinics: May see reduced demand for in-facility ultrasounds, shifting some services to portable options.
- Federal Government (CMS): Responsible for implementation, payments, and enforcement.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens equity in Medicare by aligning ultrasound with X-ray coverage, potentially reducing future litigation over reimbursement disparities. Relies on existing Social Security Act authority, avoiding new entitlements.
- Constitutional: No significant issues; it falls under Congress's spending power for social welfare programs.
- Political: Bipartisan sponsorship (by Senators Cornyn and Hassan) highlights focus on healthcare access and cost efficiency. Could influence broader debates on Medicare expansions, emphasizing non-invasive diagnostics amid rising healthcare costs, without major fiscal controversy due to targeted scope.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (2)
Sen. Hassan, Margaret Wood [D-NH], Sen. Boozman, John [R-AR]
Recent Actions
- 2025-03-27: Read twice and referred to the Committee on Finance.
- 2025-03-27: Introduced in Senate
Bill Versions
- Portable Ultrasound Reimbursement Equity Act of 2025 — issued 2025-03-27 — PDF (3 pages)