118th Congress · SENATE BILLBILL

S. 1002No UPCODE Act

A bill to amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.

Health
Introduced Mar 28, 2023
Last action Mar 28, 2023
Pipeline · Bill → Law
Step 1
Introduced
Mar 28, 2023
Step 2
Referred
Mar 28, 2023
Finance
Step 3
Committee
Step 4
Senate
Step 5
House floor
Step 6
Resolve Changes
Step 7
Signed
SummaryCRS Summary

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.

Provisions · 2 sectionsIntroduced in Senate
Timeline · 2 actions
Mar 28, 2023
Introduced in Senate
Mar 28, 2023
Read twice and referred to the Committee on Finance.