H.R. 307 — ARC Act of 2025

This section designates the short title of the Act as the “Amputation Reduction and Compassion Act of 2025” or the “ARC Act of 2025” and sets forth 11 congressional findings on atherosclerosis and peripheral artery disease (PAD), including its prevalence among an estimated 21 million Americans, approximately 200,000 annual avoidable amputations (disproportionately affecting minorities), post-amputation mortality rates of up to 52% within two years, and the cost-effectiveness of screening and evidence-based care guidelines to reduce amputations and cardiac deaths.

This section establishes a peripheral artery disease (PAD) education program under the Centers for Disease Control and Prevention (CDC), in collaboration with the Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA), clinical and patient advocacy organizations, and other stakeholders, to support, develop, and implement educational initiatives and outreach strategies informing health care professionals and the public about PAD—typically caused by narrowed arteries reducing blood flow to the limbs—and methods to reduce related amputations, particularly for at-risk populations. The section further directs the Secretary to identify and disseminate PAD best practices to health care professionals and authorizes $6 million for each of fiscal years 2026 through 2030.

This section establishes Medicare Part B coverage for peripheral artery disease (PAD) screening tests—noninvasive physiologic studies of extremity arteries (i.e., ankle-brachial index testing), arterial duplex scans of lower extremity arteries, and other tests as determined by the Secretary of Health and Human Services—furnished to at-risk beneficiaries, defined as Medicare enrollees who are age 65 or older; ages 50-64 with atherosclerosis risk factors (e.g., diabetes, smoking history, hyperlipidemia, hypertension) or family history of PAD; under age 50 with diabetes and another risk factor; or with known atherosclerotic disease in other vascular beds (e.g., coronary, carotid arteries, abdominal aortic aneurysm). It requires the Secretary, in consultation with stakeholders, to establish screening frequency standards and includes such tests in the initial preventive physical examination ("Welcome to Medicare" visit). This section provides for payment at 100% of the lesser of the actual charge or the physician fee schedule amount (thus, no coinsurance, which is typically 20% for Part B services), excludes the tests from the Part B deductible and hospital outpatient prospective payment system coinsurance requirements, denies coverage for tests furnished more frequently than standards allow, and makes conforming amendments.

This section requires state Medicaid plans to cover peripheral artery disease (PAD) screening tests—noninvasive physiologic studies of extremity arteries (i.e., ankle-brachial index testing), arterial duplex scans of lower extremity arteries, and other tests as determined by the Secretary—for at-risk beneficiaries, defined as those who are age 65 or older; ages 50-64 with atherosclerosis risk factors (e.g., diabetes, smoking history, hyperlipidemia, hypertension) or family history of PAD; under age 50 with diabetes and one additional risk factor; or with known atherosclerotic disease in other vascular beds (e.g., coronary, carotid). The Secretary must establish screening frequency standards in consultation with stakeholders. This section also prohibits cost-sharing for such tests under Medicaid and makes conforming amendments to update statutory cross-references.

This section directs the Secretary of Health and Human Services, in consultation with stakeholders, to develop quality measures for nontraumatic lower-limb major amputations that utilize diagnostic screening (including for peripheral artery disease) to promote alternative treatments such as revascularization. Not later than 18 months after enactment, the Secretary must test and validate these measures and incorporate them into Medicare quality reporting programs for applicable providers and suppliers, including (1) the merit-based incentive payment system under section 1848(q); (2) alternative payment model incentive payments under section 1833(z); (3) the shared savings program under section 1899; (4) models tested by the Center for Medicare and Medicaid Innovation (CMI) under section 1115A (i.e., payment and service delivery models to reduce Medicare expenditures while preserving or enhancing care quality); and (5) other payment systems or models specified by the Secretary.

This section adds to the list of payment and service delivery models eligible for testing by the Center for Medicare and Medicaid Innovation (CMI)—which tests models to reduce Medicare and Medicaid expenditures while preserving or enhancing care quality—a voluntary nontraumatic lower-limb major amputation prevention program at hospitals, ambulatory surgical centers, and office-based centers. The section directs the CMI director to test the model not later than 18 months after enactment.