A Democratic bill with 1 Republican cosponsor · See the cosponsor
Last activity — Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 "Access to Innovative Treatments Act of 2026," seeks to amend the Social Security Act regarding Medicare drug coverage. It establishes a formal review process for "specified national coverage determinations" where coverage for a drug or biological was denied or limited inconsistent with its approval. The process includes a required initiation of review, a 30-day public comment period, and a final decision by the Secretary. It also requires the Secretary to provide clinical evidence to the public if their decision differs from Medicare Coverage Advisory Committee recommendations. Finally, the bill prohibits applying old coverage determinations to newly approved drugs if it results in inconsistent coverage limits.
Yes· 3 of 7
- Scored +5
Would people over 65 be better off under this?
The bill provides better drug coverage protections for Medicare beneficiaries, who are primarily seniors.
- Scored +5
Would retired people be better off under this?
The bill enhances the pharmaceutical coverage protections for retirees within the Medicare system.
- Scored +5
Does this make health care easier to get in general?
The bill expands access to innovative treatments by creating a mechanism to challenge coverage denials or limits.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Review of National Coverage Determinations (Section 2(a)(1)): This provides a review process for cases where coverage for a drug or biological is denied or limited in a way that is inconsistent with its approval or licensure.
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Public Comment Period (Section 2(a)(1)(B)): This allows for a 30-day period where the public can comment on whether a coverage determination should be affirmed, reversed, or modified.
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Transparency in Decision Making (Section 2(a)(1)(C)(ii)-(iii)): The Secretary must include summaries of public comments and responses in the final decision, and must make clinical evidence and data available to the public if the decision differs from the Medicare Coverage Advisory Committee's recommendations.
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Implementation of Changes (Section 2(a)(1)(C)(iv)): If a decision is made to reverse or modify a determination, the Secretary must assign a temporary or permanent code and implement the change.
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Protection for Newly Approved Drugs (Section 2(a)(1)(6)): This prevents the Secretary from applying old national coverage determinations to newly approved drugs or biologicals if doing so would result in coverage denials or limits inconsistent with the new approval or licensure.
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Limitation on Part D Plan Determinations (Section 2(b)): Prescription drug plans or MA-PD plans are prohibited from basing decisions on a "specified national coverage determination" when determining if payment should be made for a covered Part D drug.
Potential Negative Impacts for People
- Limitation on Successive Reviews (Section 2(a)(1)(D)): A review request may be denied if the Secretary has already made a final decision regarding a review of that same determination within the previous 2-year period.
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 retired people be better off under this? — The bill enhances the pharmaceutical coverage protections for retirees within the Medicare system. Would people over 65 be better off under this? — The bill provides better drug coverage protections for Medicare beneficiaries, who are primarily seniors. Would households on low incomes be better off under this? — The bill helps ensure coverage for essential medications, which benefits low-income individuals relying on Medicare.
- Healthcare
- Does this make health care easier to get in general? — The bill expands access to innovative treatments by creating a mechanism to challenge coverage denials or limits. Does this lower the price of prescription medicines? — The bill improves access to coverage for newly approved drugs and biologicals, potentially reducing out-of-pocket costs for covered treatments. Does this put more money into Medicare, the health coverage for people over 65? — The bill improves Medicare drug coverage by establishing a review process for adverse coverage determinations.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill requires the Secretary to provide public summaries of comments and clinical evidence when decisions differ from committee recommendations.
- 6/24/2026
- Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
- 1 Cosponsor added.
- Introduced in House
John JoyceRepublican · Pennsylvania