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US SB2793
Bill
AI Summary
- Medicare Advantage organizations must include essential community providers in their networks and offer contracts to all such providers within each plan's service area
- Plans must ensure sufficient numbers and geographic distribution of essential community providers to give low-income, rural, and health professional shortage area residents reasonable and timely access to care
- Essential community providers include Federally qualified health centers, Ryan White HIV/AIDS Program facilities, Indian Health Service facilities, disproportionate share hospitals, critical access hospitals, rural referral centers, mental health and substance use treatment facilities, and other entities serving predominantly low-income or medically underserved populations
- Plans failing to meet the essential community provider standard must submit justification explaining why and describing how they will move toward compliance; the Secretary shall not approve plans with insufficient justification
- Medicare Advantage organizations must pay Federally qualified health centers at rates consistent with existing Medicare requirements under section 1857(e)(3)
Legislative Description
Ensuring Access to Essential Providers Act of 2025
Health
Last Action
Read twice and referred to the Committee on Finance.
9/11/2025
Committee Referrals
Finance9/11/2025
Full Bill Text
No bill text available