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Congress·In Committee·3 months ago

Congress would let Medicare use NP and PA primary care visits to assign patients to ACOs starting in 2026

Also known as: ACO Assignment Improvement Act of 2025

Legislative Progress

✓ Filed
Review
Senate
House
President

Impacts

Mixed Impacts(2)
Medicare
Neutral
Chronic Illness
Neutral

Key Points

  • Starting Jan. 1, 2026, Medicare will also use primary care visits with nurse practitioners, physician assistants, and clinical nurse specialists to assign patients to Medicare ACOs.
  • This changes how Medicare links you to an ACO in the shared savings program, which can affect which doctors and care teams are seen as responsible for coordinating your care.
  • For many patients who mainly see a nurse practitioner or physician assistant for primary care, this makes it more likely they’ll be assigned based on those visits instead of only physician visits.
  • If you’re assigned to an ACO, your care team may do more outreach (like care coordination calls or follow-ups) because the ACO is being measured on your care and costs.
  • The bill updates the Social Security Act rules for Medicare’s ACO program; it does not describe changes to Medicare eligibility or your right to choose providers.
HealthcareMedicare Medicaid

Milestones

2 milestones3 actions
Dec 4, 2025Senate

Read twice and referred to the Committee on Finance. (text: CR S8512)

Dec 4, 2025

Dec 4, 2025

Introduced in Senate

What Happens Next

Projected impacts based on AI analysis

During the 2026 performance year (and each year after)

ACOs update patient lists and care-management outreach based on the new assignment rule

Some people may start getting more reminders for annual wellness visits, chronic condition check-ins, or help scheduling follow-ups because their ACO “ownership” is clearer.

Early to mid-2026

Clinics adjust documentation and workflows so NP/PA/CNS primary care services are captured correctly for assignment

You might notice more consistent coding of visits, more structured questionnaires, or more coordinated referrals, as clinics try to make sure Medicare recognizes the primary care you received.

Related News

1 article
Becker's Hospital Review·3 months ago

Federal bill would recognize NPs, PAs in Medicare ACO models

Covers the Dec. 4, 2025 introduction of the ACO Assignment Improvement Act and explains how ACO beneficiary assignment would also reflect primary care services furnished by NPs, PAs and clinical nurse specialists.

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Source Information

Document Type

Congressional Bill

Official Title

ACO Assignment Improvement Act of 2025

Bill NumberS 3350
Congress119th Congress
ChamberSenate
Latest ActionRead twice and referred to the Committee on Finance. (text: CR S8512)

Sponsor

Cosponsors

(1)
D: 1

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.