No Medicare Clawbacks Act of 2026

Key Points

• This bill stops private insurance companies from taking back money they already paid for a person's medical care. This often happens when a person gets Medicare coverage that starts retroactively, meaning it covers health services that happened in the past.
• Right now, some insurance companies try to get their money back if they find out Medicare should have paid for a doctor visit or hospital stay instead. This can leave patients or doctors stuck with unexpected bills or complicated paperwork long after the care was provided.
• Under this plan, an insurance company cannot take back its payment if the person was up to date on their insurance premiums. It applies specifically to times when Medicare Part A coverage is backdated to cover earlier medical needs.
• The goal is to protect people who have both a private work insurance plan and Medicare. It ensures that once a medical bill is paid, the insurance company cannot change its mind later just because Medicare coverage kicked in for that same time period.

Impact Analysis

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