No UPCODE Act

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.

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Timeline

1. 25 March 2025

   Introduced

   Read twice and referred to the Committee on Finance.

   Source: IntroReferral

2. 25 March 2025

   Introduced

   Introduced in Senate

   Source: IntroReferral

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

2 official files

• Introduced in Senate

  Introduced in Senate · EN · 25 March 2025

  DownloadOpen at official source

• Introduced in Senate

  summary · EN · 25 March 2025

  Open at official source

Sponsors

• Sen. Cassidy, Bill [R-LA] · R · Sponsor
• Sen. Merkley, Jeff [D-OR] · D · Sponsor
• · ssfi00 · Standing

Related records

• related to ← To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and for other purposes.