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Medicare Coverage and Payment Reform for Advanced Wound Care Products.

This bill ensures permanent Medicare coverage for advanced skin substitute products used in treating chronic wounds, standardizing access for beneficiaries. It establishes a new, inflation-adjusted payment system for these products, aiming for cost stability regardless of where the treatment is provided. Crucially, it introduces strict measures to combat fraud and waste among high-volume providers.
Key points
Medicare Part B coverage is mandated for advanced skin substitute products used in wound treatment, ensuring access regardless of the care setting.
A new, standardized payment rate for these products is established, updated annually based on inflation, starting January 2026.
New rules target fraud: providers with the highest billing amounts will face mandatory reviews or prior authorization to prevent abuse.
Payment will only cover the necessary portion of the product required for the wound treatment, explicitly excluding reimbursement for wasted material.
article Official text account_balance Process page
Introduced
Citizen Poll
No votes cast
Additional Information
Print number: 119_HR_6852
Sponsor: Rep. Evans, Gabe [R-CO-8]
Process start date: 2025-12-18
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Summarized by: gemini-flash-latest
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

Advanced Wound Care and Regenerative Medicine Access and Reform Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 119_HR_6852.

Which chamber initiated this legislation?

This legislation was initiated in the House of Representatives.

When did the legislative process begin?

The process officially started on 2025-12-18.

What are the main provisions?

Key points include:

  • Medicare Part B coverage is mandated for advanced skin substitute products used in wound treatment, ensuring access regardless of the care setting.
  • A new, standardized payment rate for these products is established, updated annually based on inflation, starting January 2026.
  • New rules target fraud: providers with the highest billing amounts will face mandatory reviews or prior authorization to prevent abuse.
  • Payment will only cover the necessary portion of the product required for the wound treatment, explicitly excluding reimbursement for wasted material.
What is the specific legal status?

The current status is Introduced.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Rep. Evans, Gabe [R-CO-8].

What is the latest detailed status?

The latest detailed status is: Introduced in House

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2026-01-22.

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Health Benefits