Medicare Fraud Detection and Deterrence Act of 2025This bill requires the Centers for Medicare & Medicaid Services (CMS) to deactivate the standard unique health identifiers of health care providers that are excluded from federal health care programs because of fraud, waste, or abuse.The bill also requires (1) any data submitted by Medicare Advantage plans with respect to durable medical equipment, prosthetics or orthotics, laboratory tests, imaging tests, or home health services to include the standard unique health identifier of the associated provider or supplier; and (2) health care practitioners who are employed by or contract with telehealth companies to use a specialized claims modifier (developed by CMS) for Medicare telehealth services.
Preventing Medicare Telefraud ActThis bill establishes conditions for payment of certain telehealth services, laboratory tests, and durable medical equipment under Medicare.Specifically, the bill conditions payment for certain high-cost laboratory tests and durable medical equipment that are ordered via telehealth on at least one in-person visit during the preceding six-month period. Additionally, practitioners must submit claims for separately billable telehealth services under the practitioner's unique national provider identification number.
Requires the executive office of health and human services to apply to the Centers for Medicare and Medicaid Services for a state plan amendment for reimbursement for health services in a school.
Requires the executive office of health and human services to apply to the Centers for Medicare and Medicaid Services for a state plan amendment for reimbursement for health services in a school.
Kids' Access to Primary Care Act of 2025This bill modifies payments for Medicaid primary care services. Specifically, the bill applies a Medicare payment rate floor to Medicaid primary care services that are provided after the date of enactment of the bill and extends the payment rate to additional types of practitioners (e.g., obstetricians).The Centers for Medicare & Medicaid Services must conduct a study on the number of children enrolled in Medicaid, the number of providers receiving payment for primary care services, and associated payment rates before and after the bill's implementation.
Requires the executive office of health and human services to increase Medicaid payment rates for primary care services furnished by primary care providers to be commensurate with Medicare rates.
Establishes a family caregiver program which shall receive reimbursement from Medicaid and directs the commissioner of health to secure approval from the federal Centers for Medicare & Medicaid Services for family caregivers.
Community Health, Department of; submit a waiver request to the federal Centers for Medicare and Medicaid Services to authorize the qualification of certain caregivers for Medicaid reimbursement