No UPCODE Act
The summary
What this bill does
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.
Legislative timeline
From introduction
Mar 25, 2025
Introduced & referred to committee
Congressional support
Sponsors & Cosponsors
U.S. Representative - LA · R-LA
1 cosponsor
Roll-call vote
The vote, by member
The vote, by member
VERSION CHANGES
What changed,
and where.
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Bill Metadata
| Congress | 119 |
| Bill Type | S |
| Bill Number | 1105 |
| Origin Chamber | Senate |
| Current Status | Read twice and referred to the Committee on Finance. |
| Policy Area | Health |
| Primary Committee | Not assigned |
| Introduced | March 25, 2025 |
| Latest Action | March 25, 2025 |
| Cosponsors | 1 · House vote — · — views |