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CIVIC HERALD
HR 9544 · 119th Congress · HouseIn committee

Save MEDICARE Act of 2026

In plain language: 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.

Provisional: our plain-language summary, pending review.

Provisionalunreviewed: impact, issue tags, provisions, stakeholders, summary
People affectedThe 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 magnitudeno CBO estimate published
Reach82provisional · pending reviewrigor: heuristic llm
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Issues

What this bill touches.

Spending vs. restraint−50Veterans' care delivery+45Government role in coverage+50Federal vs. state/local−35

The sign shows the bill's direction on each issue (+ toward, − away); the number is its magnitude. Color never encodes good or bad, and never party.

Who it affects

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.provisional
  • Medicare recovery audit contractorsSecures contracts to identify and recoup Medicare Advantage overpayments with contingency fees of up to 20 percent of recovered funds.provisional
  • 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.provisional

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.provisional
  • 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.provisional
  • 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.provisional

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.provisional

Dollar-level funding (FEC sector totals) is coming in a later phase.

What it does

The provisions, in plain language.

  1. Prohibits the Department of Health and Human Services, starting in 2028, from using diagnoses gathered through chart reviews or health risk assessments to adjust health status payment rates for Medicare Advantage and Part D prescription drug plans.

    Sec. 2(b)provisional
  2. Ends the Medicare Advantage quality bonus payment program after 2028.

    Sec. 3provisional
  3. Requires annual reductions to Medicare Advantage base payment benchmarks starting in 2028 to adjust for favorable selection of healthier enrollees into private plans compared to traditional Medicare.

    Sec. 4(b)provisional
  4. Imposes strict deadlines on Medicare Advantage risk-adjustment data validation audits and appeals, authorizes sampling extrapolation and retroactive adjustments, bars judicial review of audit decisions, and deducts a 0.02 percent fee from plan payments to fund audits starting in 2028.

    Sec. 5(a)provisional
  5. Requires the Department of Health and Human Services to hire recovery audit contractors to recoup Medicare Advantage overpayments, paying them up to a 20 percent contingency fee and assessing a 100 percent penalty plus interest against overpaid plans.

    Sec. 5(b)provisional
  6. Requires Medicare Advantage and Part D plans, starting in 2028, to reimburse the Department of Veterans Affairs for covered medical care, prescription drugs, and services provided to enrolled veterans without requiring prior authorization or utilization management.

    Sec. 6(a)provisional
  7. Authorizes states to enforce federal Medicare Advantage standards on private insurers operating within their borders and directs federal regulators to coordinate enforcement with state officials.

    Sec. 7provisional
  8. Prohibits Medicare Advantage insurers from offering contracts that pay health care providers a percentage of plan premiums or provide financial incentives tied to diagnostic coding starting in 2028.

    Sec. 8provisional

How your members of Congress line up

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Timeline

How it moved.

  1. Jul 17, 2026Referred to the Subcommittee on Health.
  2. Jun 30, 2026Introduced in House
  3. Jun 30, 2026Introduced in House

The original text

Read it for yourself.

Sources & provenance

Congress.govrefreshed 9 days ago

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