No UPCODE Act
Official title: A bill to amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.
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Read twice and referred to the Committee on Finance.
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.
- Introduced in Senate Formatted Text PDF Formatted XML
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Cite this page
U.S. Congress. (2026). S. 1002: No UPCODE Act. 118th Congress. Open America. https://openamerica.io/bill/118-S-1002/
"S. 1002: No UPCODE Act." 118th Congress, 2026, Open America, https://openamerica.io/bill/118-S-1002/.
S. 1002, 118th Cong. (2026), https://openamerica.io/bill/118-S-1002/.
[S. 1002: No UPCODE Act](https://openamerica.io/bill/118-S-1002/)