Chronic Care Management Improvement Act of 2026
- Sponsor
- Rep. DelBene, Suzan K. [D-WA-1]
- Committees
- Ways and Means Committee (primary)
- Last action
- Apr 14, 2026
Bottom line
The bill aims to enhance access to chronic care management services for Medicare Part B beneficiaries by removing all patient financial responsibility, potentially increasing federal Medicare expenditures.
What it actually does
This bill amends title XVIII of the Social Security Act to eliminate cost-sharing responsibilities for chronic care management services under Medicare Part B. Specifically, it removes both the deductible and coinsurance requirements for these services when furnished on or after January 1, 2027, meaning Medicare beneficiaries would pay nothing out-of-pocket.
Proponents argue
Proponents argue that removing financial barriers to chronic care management will significantly improve access for Medicare beneficiaries, leading to better adherence to care plans, improved health outcomes, and potentially reducing more costly acute care episodes and hospitalizations in the long run. They contend it supports proactive health management for those with ongoing conditions.
Opponents contend
Opponents might raise concerns that eliminating cost-sharing for these services will increase federal spending and the burden on the Medicare program, potentially leading to higher taxes or premiums for other services. They may also argue it could lead to overutilization of services if patients no longer have any financial stake in their use.
The bill is exceptionally short and clearly written, making it very accessible for any reader to understand its core provisions and implications quickly.
Section 2(1) of the bill, amending Section 1833(a)(1) of the Social Security Act
Elimination of Coinsurance for Chronic Care Management Services
This provision modifies the Social Security Act to ensure that for chronic care management services provided to Medicare Part B beneficiaries on or after January 1, 2027, Medicare will pay 100 percent of the approved amount. This change means beneficiaries will no longer be responsible for the 20 percent coinsurance that typically applies to Part B services, effectively making these services free at the point of care.
Supporters argue
Supporters argue that removing the coinsurance barrier will encourage more consistent engagement in chronic care management, which is crucial for preventing disease progression and avoiding more expensive emergency or inpatient care. This makes essential care more affordable for vulnerable populations.
Critics contend
Critics may contend that shifting the entire cost burden to Medicare could lead to an unsustainable increase in program expenditures without guaranteed proportional health improvements. They might also suggest that some level of cost-sharing encourages judicious use of services.
Tradeoffs
This provision balances the goal of improving patient access and potentially better health outcomes against the immediate increase in federal spending and the potential for higher utilization rates.
Section 2(2) of the bill, amending Section 1833(b) of the Social Security Act
Exemption of Chronic Care Management Services from Deductible
This provision adds chronic care management services to the list of services under Medicare Part B that are exempt from the annual deductible. Starting January 1, 2027, beneficiaries will not need to meet their annual Part B deductible before Medicare begins covering these specific chronic care management services, further reducing their upfront out-of-pocket expenses.