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S-45832026-05-20

《2026年优质医疗服务合法化法案》

YourVoice.Now 摘要

企业利益对普通家庭的影响

允许医疗保险(Medicare)患者与医生签订私人协议,使医生可收取高于医保规定的费用,差额部分由患者自付。

企业利益

  • 联邦医疗保险收费限制规则——签约服务的第1848(g)条收费上限被取消,使医疗服务提供者可向患者收取超过标准联邦医疗保险费率的费用

对普通家庭的影响

  • 患者自付费用风险——签约医疗服务提供者可收取超出联邦医疗保险费率上限的费用,超出部分由患者自行承担
  • 州级收费上限保护——联邦优先原则取消了各州对联邦医疗保险签约服务医师收费进行限制的权力

详细内容

联邦医疗保险目前对医生向患者收取的费用设有上限:参与计划的医生须以联邦医疗保险费率作为全额付款,而未参与计划的医生收费不得超过联邦医疗保险费率的115%。本法案创建了一种新的合同模式,允许联邦医疗保险患者与医生签订书面协议,自行约定付款条款,包括超过联邦医疗保险标准费率的收费。患者仍可提交联邦医疗保险报销申请并获得标准报销,但须自行承担医生收费超出标准的部分。限制医生收费的州法律将被本联邦法律取代,同时享有联邦医疗保险和医疗补助双重保障的参保人不得使用这一新的合同选项。

国会摘要

Legalizing Premium Health Care Act of 2026 This bill allows any Medicare beneficiary to enter into a contract with an eligible professional, regardless of whether the professional is participating in Medicare, for any item or service covered by Medicare. Such beneficiaries may submit a claim for Medicare payment in the amount that would otherwise apply, except that, where the professional is considered to be non-participating, payment shall be made as if the professional were participating. An eligible professional is a physician, physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse-midwife, clinical social worker, clinical psychologist, registered dietitian or nutrition professional, physical or occupational therapist, qualified speech-language pathologist, or qualified audiologist. A Medicare beneficiary must agree in writing in such a contract to (1) pay the eligible professional for a Medicare-covered item or service; and (2) submit, in lieu of the eligible professional, a claim for Medicare payment. However, a beneficiary may negotiate, as a term of the contract, for the eligible professional to file such claims on the beneficiary's behalf. The bill preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.

详细信息

国会届次
undefinedth
议院
状态
行动
提交参议院
行动日期
2026-05-20
添加日期
来源
Congress.gov →

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