In committee
Save MEDICARE Act of 2026
Starting in 2028, this bill reduces federal payments to private Medicare Advantage and Medicare prescription drug plans by ending quality bonus programs and preventing insurers from using chart reviews or one-time health assessments to increase their risk-adjusted government funding. It also requires private Medicare plans to reimburse the Department of Veterans Affairs whenever enrolled veterans receive covered medical treatment at VA facilities. In addition, the legislation bans insurers from offering doctors financial incentives for reporting extra diagnoses, speeds up federal audits to recoup overpayments with penalties, and empowers state regulators to enforce Medicare Advantage rules.
People affected—The bill broadens regulations governing all Medicare Advantage and Part D plans, enrolled beneficiaries, healthcare providers, and veterans receiving VA care, but does not quantify the specific population in the text.
Fiscal magnitude—no CBO estimate published
Reach82provisional · pending reviewrigor: heuristic llm
What this bill touches.
Spending vs. restraint−50Veterans' care delivery+45Government role in coverage+50Federal vs. state/local−35
Who it helps · who it burdens.
Who it helps
- Department of Veterans AffairsReceives mandatory reimbursement from Medicare Advantage and Part D plans for care provided to enrolled veterans and gains stronger third-party recovery powers with double or triple damages for nonpayment.
- Medicare recovery audit contractorsSecures contracts to identify and recoup Medicare Advantage overpayments with contingency fees of up to 20 percent of recovered funds.
- State insurance regulatorsGain direct legal authority to enforce federal Medicare Advantage standards against private insurers operating within their borders and coordinate enforcement with federal regulators.
Who it burdens
- Medicare Advantage organizations and Part D sponsorsFaces major payment reductions via exclusions of chart-review diagnoses, elimination of quality bonuses, favorable selection benchmark cuts, a 0.02 percent audit fee, recoupment penalties up to 100 percent, mandatory reimbursement of the VA, and state-level enforcement.
- Third-party insurers and liable tortfeasorsSubject to strict 45-day claim response deadlines, mandatory reporting of veteran recipients, restrictions on distributing settlement proceeds, interest charges, and civil penalties or treble damages for unpaid VA claims.
- Health care providers contracting with Medicare Advantage plansAre barred from entering into Medicare Advantage contracts that pay a percentage of plan premiums or provide financial incentives tied to diagnostic coding.
Who backs it
- Medicare Advantage organizationsA 0.02 percent fee is deducted from payments to Medicare Advantage organizations to fund Risk Adjustment Data Validation (RADV) audits.