A Republican bill with no cosponsors
Last activity — Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
This bill, known as the "SMART Health Care Act," proposes several changes to the Social Security Act. It aims to improve risk adjustment under Medicare Advantage by requiring the use of two years of diagnostic data starting in 2026. The legislation also promotes Medicare site-neutral payments for on-campus outpatient departments. Additionally, it seeks to increase Medicare access for rural communities through physician-owned hospitals. Finally, the bill includes provisions to make drugs more affordable for Medicare patients and improves quality of care at skilled nursing facilities.
Yes· 3 of 8
- Scored +8
Does this lower the price of prescription medicines?
The bill mandates that outpatient drugs be provided at a price not exceeding the purchase price minus discounts or rebates.
- Scored +7
Would people over 65 be better off under this?
The bill reduces drug costs and improves Medicare access for seniors.
- Scored +6
Would people in rural areas be better off under this?
The bill expands Medicare access for rural communities via physician-owned hospitals.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Improved Medicare Advantage Risk Adjustment: Starting in 2026, the Secretary will use two years of diagnostic data under the risk adjustment methodology, which is intended to improve risk adjustment under Medicare Advantage (Section 2).
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Increased Rural Medicare Access: The bill changes requirements for designated health services in rural areas to increase Medicare access for rural communities via physician-owned hospitals (Section 4).
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Drug Affordability for Medicare Patients: Covered entities must ensure patients receive covered outpatient drugs at a price not exceeding the purchase price minus any additional discounts or rebates (Section 5).
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Increased Oversight of Drug Pricing: The Secretary is tasked with establishing a mechanism to ensure compliance, adjust reimbursement rates, and publicly report total amounts paid and received for covered outpatient drugs (Section 5).
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Quality of Care Improvements: The bill adjusts the mechanism for quality of care at skilled nursing facilities by allowing for a range of 2 to 5 percentage points as determined by the Secretary (Section 6).
Potential Negative Impacts for People
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Changes to Site-Neutral Payments: The bill implements a sunset of certain exceptions for applicable items and services on or after January 1, 2026 (Section 3(a)).
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Impact on On-Campus Outpatient Departments: The bill modifies how payments are handled for services furnished by on-campus outpatient departments of a provider, directing that payment be the amount determined under the fee schedule for a physician office setting (Section 3(b)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would people over 65 be better off under this? — The bill reduces drug costs and improves Medicare access for seniors. Would people in rural areas be better off under this? — The bill expands Medicare access for rural communities via physician-owned hospitals. Would households on low incomes be better off under this? — The bill lowers drug costs for Medicare patients which disproportionately benefits low-income individuals.
- Healthcare
- Does this lower the price of prescription medicines? — The bill mandates that outpatient drugs be provided at a price not exceeding the purchase price minus discounts or rebates. Does this make health care easier to get in general? — The bill increases Medicare access for rural communities through physician-owned hospitals. Does this put more money into Medicare, the health coverage for people over 65? — The bill improves risk adjustment by using two years of diagnostic data to better reflect patient health status.
- Economy And Finance
- Does this give people more protection from unfair business practices? — The bill requires covered entities to pass drug discounts and rebates directly to patients.
- Social Issues And Justice
- Is this likely to lift people out of poverty? — The bill reduces out-of-pocket costs for prescription drugs for Medicare patients.
- 5/6/2025
- Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House