Legis Daily

No UPCODE Act

USA118th CongressS-1002| Senate 
| Updated: 3/28/2023
Bill Cassidy

Bill Cassidy

Republican Senator

Louisiana

Cosponsors (1)
Jeff Merkley (Democratic)

Finance Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
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.
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Timeline
Mar 28, 2023
Introduced in Senate
Mar 28, 2023
Read twice and referred to the Committee on Finance.
  • March 28, 2023
    Introduced in Senate


  • March 28, 2023
    Read twice and referred to the Committee on Finance.

Health

No UPCODE Act

USA118th CongressS-1002| Senate 
| Updated: 3/28/2023
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.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Mar 28, 2023
Introduced in Senate
Mar 28, 2023
Read twice and referred to the Committee on Finance.
  • March 28, 2023
    Introduced in Senate


  • March 28, 2023
    Read twice and referred to the Committee on Finance.
Bill Cassidy

Bill Cassidy

Republican Senator

Louisiana

Cosponsors (1)
Jeff Merkley (Democratic)

Finance Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted