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Congress·In Committee·5 months ago

Medicare: New Payment Rules for Skin Substitutes

Also known as: Skin Substitute Access and Payment Reform Act

Legislative Progress

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Key Points

  • This bill changes how Medicare pays for 'skin substitutes,' which are special materials used to help heal serious wounds. Currently, prices can vary wildly, but this plan would create a single price based on average costs and inflation to keep prices steady.
  • Starting in 2026, Medicare will pay 80% of the set cost for these products. This aims to make sure patients can get the treatments they need without the government overpaying for expensive brands that do the same job as more affordable ones.
  • To stop waste and fraud, the government will track the top 3% of doctors and clinics that spend the most on these products. These high-spending providers will have their bills double-checked by Medicare before they are allowed to receive payment.
  • If a high-spending clinic continues to submit improper bills, they could be banned from the Medicare program entirely. This helps protect taxpayer money from being used on unnecessary or overpriced medical treatments.

Milestones

2 milestones2 actions
Oct 17, 2025House

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.

Oct 17, 2025

Introduced in House

Source Information

Document Type

Congressional Bill

Official Title

Skin Substitute Access and Payment Reform Act

Bill NumberHR 5768
Congress119th Congress
ChamberHouse of Representatives
Latest ActionReferred 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.

Sponsor

Cosponsors

(7)
D: 2R: 5

Analysis generated by AI. While we strive for accuracy, this should not be considered legal or professional advice. Always verify information with official government sources.