No UPCODE Act
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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.
Read twice and referred to the Committee on Finance.
- Introduced in Senate Formatted Text PDF Formatted XML
Cite this page
U.S. Congress. (2026). S. 1105: No UPCODE Act. 119th Congress. Open America. https://openamerica.io/bill/119-S-1105/
"S. 1105: No UPCODE Act." 119th Congress, 2026, Open America, https://openamerica.io/bill/119-S-1105/.
S. 1105, 119th Cong. (2026), https://openamerica.io/bill/119-S-1105/.
[S. 1105: No UPCODE Act](https://openamerica.io/bill/119-S-1105/)