In the News

A new bipartisan bill introduced in Congress would eliminate a key cost‑sharing requirement tied to Medicare’s chronic care management services.

If passed, lawmakers say this could expand access for seniors with multiple chronic conditions and alter how providers are paid for coordinating ongoing care.

The legislation, the Chronic Care Management Improvement Act, has drawn support from dozens of major healthcare and patient advocacy organizations, who say there are currently low participation rates under the current payment structure.

Why It Matters

The proposal targets a 20 percent coinsurance requirement that Medicare beneficiaries must currently pay to receive chronic care management services, which include behind‑the‑scenes coordination such as tracking patient records and managing care transitions.

While the monthly out‑of‑pocket cost is often relatively small, usually around $12, lawmakers and provider groups say it can still discourage participation, especially for seniors living on fixed incomes.

What To Know

The Chronic Care Management Improvement Act would remove the coinsurance requirement for Medicare beneficiaries receiving chronic care management services.

Those services were first made separately billable under the Medicare Physician Fee Schedule in 2015 and cover non‑face‑to‑face care coordination, including maintaining care plans, sharing records during care transitions, and scheduling follow‑up services.

Supporters of the bill say the current billing structure can be confusing for beneficiaries, since charges may appear even when no in‑person medical appointment occurs. As a result, usage of chronic care management services has remained low.

According to the most recent available data, only about 882,000 Medicare beneficiaries, or roughly 4 percent of those eligible, received these services, even though more than 22 million beneficiaries qualify.

The legislation was introduced in the House by Representative Suzan DelBene, a Democrat from Washington, alongside Representative Mike Kelly, a Republican from Pennsylvania.

“Removing barriers to chronic care management is key to lowering healthcare costs and delivering better results for seniors,” DelBene said in a statement. “Chronic health conditions account for 90 percent of national health care spending, yet too few seniors are receiving these incredibly impactful services. Dropping cost-sharing requirements would increase access to these services for more seniors.”

More than 40 healthcare and patient advocacy groups have endorsed the proposal, including the American Medical Association, the American Hospital Association, AARP, and the National Patient Advocate Foundation.

“Better coordination can lead to fewer hospital visits and more timely execution of care. The tradeoff is increased utilization and added cost pressure on an already fragmented system. But removing friction tends to improve outcomes, and that is a step in the right direction,” Kevin Thompson, the CEO of 9i Capital Group and the host of the 9innings podcast, told Newsweek.

“The real issue is, how much would it cost? In an era where the administration wants to spend less on healthcare, the likelihood of passage is murky at best.”

What To Watch For Next

The bill has been formally introduced in the House and will need to move through the committee process before it can advance to a full vote. Supporters say that eliminating cost‑sharing could lead to broader use of chronic care management services, potentially improving patient outcomes while reducing long‑term Medicare spending.

However, whether the proposal gains traction will likely depend on its budgetary impact and broader negotiations over Medicare payment policies.

“If this passes, you'll see more seniors enrolled in chronic care management. Not because Medicare changed, because the friction disappeared. That means more coordinated care, fewer duplicate tests, better medication adherence, and lower total costs,” Michael Ryan, a finance expert and the founder of MichaelRyanMoney.com, told Newsweek.

“For Medicare, that eases pressure on future premium hikes instead of adding to it. For seniors, it means less juggling between doctors' offices.”