Legis Daily

Ensuring Access to Essential Providers Act of 2025

USA119th CongressS-2793| Senate 
| Updated: 9/11/2025
Bill Cassidy

Bill Cassidy

Republican Senator

Louisiana

Cosponsors (1)
Ben Ray Luján (Democratic)

Finance Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This legislation amends the Social Security Act to mandate that Medicare Advantage (MA) plans include essential community providers in their service area networks. The core purpose is to ensure reasonable and timely access to a broad range of healthcare services for low-income individuals , those residing in rural areas , or individuals in health professional shortage areas . Under the new standard, MA organizations must include a sufficient number and geographic distribution of these providers and offer contracts to each available essential community provider within a plan's service area. If an MA plan does not meet this requirement, the organization must provide a detailed explanation and describe how its network will still adequately serve vulnerable populations and move towards compliance. The Secretary has the authority to deny plan approval if the justification is deemed insufficient. The bill broadly defines an essential community provider as one that predominantly serves low-income, medically underserved individuals. This definition includes Federally Qualified Health Centers, facilities funded by the Ryan White HIV/AIDS Program, Indian Health Service facilities, various types of hospitals, and mental health or substance use treatment facilities, among others.
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Timeline
Sep 11, 2025
Introduced in Senate
Sep 11, 2025
Read twice and referred to the Committee on Finance.
  • September 11, 2025
    Introduced in Senate


  • September 11, 2025
    Read twice and referred to the Committee on Finance.

Health

Ensuring Access to Essential Providers Act of 2025

USA119th CongressS-2793| Senate 
| Updated: 9/11/2025
This legislation amends the Social Security Act to mandate that Medicare Advantage (MA) plans include essential community providers in their service area networks. The core purpose is to ensure reasonable and timely access to a broad range of healthcare services for low-income individuals , those residing in rural areas , or individuals in health professional shortage areas . Under the new standard, MA organizations must include a sufficient number and geographic distribution of these providers and offer contracts to each available essential community provider within a plan's service area. If an MA plan does not meet this requirement, the organization must provide a detailed explanation and describe how its network will still adequately serve vulnerable populations and move towards compliance. The Secretary has the authority to deny plan approval if the justification is deemed insufficient. The bill broadly defines an essential community provider as one that predominantly serves low-income, medically underserved individuals. This definition includes Federally Qualified Health Centers, facilities funded by the Ryan White HIV/AIDS Program, Indian Health Service facilities, various types of hospitals, and mental health or substance use treatment facilities, among others.
View Full Text

Suggested Questions

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

Timeline
Sep 11, 2025
Introduced in Senate
Sep 11, 2025
Read twice and referred to the Committee on Finance.
  • September 11, 2025
    Introduced in Senate


  • September 11, 2025
    Read twice and referred to the Committee on Finance.
Bill Cassidy

Bill Cassidy

Republican Senator

Louisiana

Cosponsors (1)
Ben Ray Luján (Democratic)

Finance Committee

Health

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