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No UPCODE Act
12/15/2023, 4:06 PM
Summary of Bill S 1002
The No UPCODE Act, also known as Bill 118 s 1002, is a piece of legislation currently being considered by the US Congress. The purpose of this bill is to address the issue of unfair pricing practices in the pharmaceutical industry.
The bill specifically targets a practice known as "UPCODE," where pharmaceutical companies manipulate billing codes to overcharge for medications. This practice can result in higher costs for patients and increased profits for the companies.
If passed, the No UPCODE Act would prohibit pharmaceutical companies from engaging in UPCODE practices and impose penalties for those found in violation of the law. The bill also includes provisions for increased transparency and oversight of drug pricing to ensure that patients are not being unfairly charged for their medications. Overall, the No UPCODE Act aims to protect consumers from price gouging in the pharmaceutical industry and promote fair and transparent pricing practices. It is currently being debated in Congress and has garnered support from both sides of the aisle.
The bill specifically targets a practice known as "UPCODE," where pharmaceutical companies manipulate billing codes to overcharge for medications. This practice can result in higher costs for patients and increased profits for the companies.
If passed, the No UPCODE Act would prohibit pharmaceutical companies from engaging in UPCODE practices and impose penalties for those found in violation of the law. The bill also includes provisions for increased transparency and oversight of drug pricing to ensure that patients are not being unfairly charged for their medications. Overall, the No UPCODE Act aims to protect consumers from price gouging in the pharmaceutical industry and promote fair and transparent pricing practices. It is currently being debated in Congress and has garnered support from both sides of the aisle.
Congressional Summary of S 1002
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act
This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data.
Specifically, the bill requires the Centers for Medicare & Medicaid Services (CMS) to use two years of diagnostic data in its risk adjustment methodology for MA payments. It also prohibits the CMS from using diagnoses that are collected from chart reviews or health risk assessments when adjusting payments based on health status. The CMS must also take into account any differences in coding patterns between MA and traditional Medicare when determining MA payment adjustments.
Current Status of Bill S 1002
Bill S 1002 is currently in the status of Bill Introduced since March 28, 2023. Bill S 1002 was introduced during Congress 118 and was introduced to the Senate on March 28, 2023. Bill S 1002's most recent activity was Read twice and referred to the Committee on Finance. as of March 28, 2023
Bipartisan Support of Bill S 1002
Total Number of Sponsors
1Democrat Sponsors
0Republican Sponsors
1Unaffiliated Sponsors
0Total Number of Cosponsors
2Democrat Cosponsors
2Republican Cosponsors
0Unaffiliated Cosponsors
0Policy Area and Potential Impact of Bill S 1002
Primary Policy Focus
HealthComments
Sponsors and Cosponsors of S 1002
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