Technical corrections only. The changes between v2 and v3 reflect the bill's progression through the House of Representatives, updating its status from "Reported in House" to "Engrossed in House" and changing the document type from "A BILL" to "AN ACT". There are no substantive policy changes in the legislative text.
Choices for Increased Mobility Act of 2026
- Sponsor
- Rep. Joyce, John [R-PA-13]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Oct 14, 2026
Bottom line
The bill aims to improve access to advanced ultralightweight manual wheelchairs for Medicare beneficiaries by adjusting payment rules and ensuring cost transparency, potentially increasing out-of-pocket costs for some.
What it actually does
This bill amends the Social Security Act to require Medicare to establish separate billing codes for ultralightweight manual wheelchairs based on their construction material, specifically distinguishing between those made with titanium or carbon fiber and those without. It clarifies that suppliers can charge beneficiaries the difference between their actual charge for higher-end wheelchairs and the Medicare payment amount, and allows the Secretary to mandate beneficiary notification of this potential out-of-pocket cost.
Proponents argue
Supporters argue that this bill addresses a critical gap in Medicare coverage by recognizing the superior quality, durability, and functional benefits of ultralightweight manual wheelchairs made with advanced materials like titanium and carbon fiber. They contend that these materials offer significant improvements in mobility, independence, and long-term health outcomes for users, reducing secondary complications and improving quality of life, and that current payment structures do not adequately cover their cost.
Opponents contend
Opponents might express concern that allowing suppliers to charge beneficiaries the difference could lead to increased out-of-pocket costs for vulnerable Medicare recipients, creating a two-tiered system where access to the best equipment depends on a beneficiary's ability to pay. They might argue that this could exacerbate health disparities and that Medicare should fully cover medically necessary equipment, or that the cost difference should be absorbed by suppliers or through a more comprehensive payment adjustment.
The bill is very short and straightforward, making it highly accessible for readers to understand its core provisions.
Section 2, amending Section 1834(a) of the Social Security Act, new paragraph (24)(A).
Mandate for Differentiated HCPCS Codes
This provision requires the Secretary of Health and Human Services to create distinct billing codes (HCPCS codes) for ultralightweight manual wheelchairs. These codes must differentiate between wheelchairs whose bases are constructed from advanced materials like titanium or carbon fiber and those made from other materials, for items furnished starting January 1, 2028. This aims to allow for different payment rates based on material cost and quality.
Supporters argue
Supporters argue that separate codes are essential to recognize the clinical value and higher manufacturing costs of advanced material wheelchairs, which offer superior performance and durability. This differentiation is seen as a necessary step to ensure beneficiaries can access the most appropriate equipment for their needs.
Critics contend
Critics might argue that creating separate codes could complicate the billing system and potentially lead to suppliers prioritizing more expensive options, even if less costly alternatives are sufficient for some patients.
Tradeoffs
The tension lies between ensuring fair reimbursement for advanced technology and preventing unnecessary cost escalation within the Medicare program.
Section 2, amending Section 1834(a) of the Social Security Act, new paragraph (24)(B).
Payment and Out-of-Pocket Cost Clarification
This provision clarifies that for ultralightweight manual wheelchairs made with titanium or carbon fiber, Medicare will pay suppliers the amount it would normally pay for such a wheelchair (as per existing rules). Crucially, it explicitly allows suppliers to charge the beneficiary the difference between their actual charge for the wheelchair and the Medicare payment amount. To protect beneficiaries, the Secretary may require suppliers to issue a notice informing individuals of their potential financial liability before purchase or rental.
The Secretary may require a supplier to issue a notice to the individual (in a form and manner determined by the Secretary) prior to the purchase or rental of such ultralightweight manual wheelchair by such individual, to inform them of potential financial liability.
Section 2, amending Section 1834(a) of the Social Security Act, new paragraph (24)(B)(iii).
Why it matters:The discretionary language ('may require') is standard legislative practice when granting agency flexibility, but it also means the protection is not guaranteed unless the Secretary actively implements it.
Case for: Supporters argue that giving the Secretary discretion allows for flexibility in implementation, ensuring the notice requirements are practical and effective without imposing undue administrative burdens if not deemed necessary in all circumstances.
Case against: Critics might argue that making this protection optional weakens beneficiary safeguards, as it leaves the decision to an administrative body rather than mandating transparency directly in law. This could lead to inconsistent application or a lack of notice in some cases.
Estimated impact: If not implemented, beneficiaries might be unaware of significant out-of-pocket costs until the point of sale, leading to financial surprises. If implemented, it provides crucial transparency.