Medicare Payment Reform for Skin Substitutes: Ensuring Access and Lowering Costs.
This law changes how Medicare pays for advanced skin substitute products used to treat chronic, non-healing wounds, such as diabetic foot ulcers. The goal is to curb rising Medicare costs by standardizing payments and ensuring that all safe and effective wound care products are covered equally. This reform aims to guarantee stable access to these necessary therapies for Medicare beneficiaries while allowing doctors to choose the best product based on patient needs, not price incentives.
Key points
Medicare will establish a single, averaged payment rate for all skin substitute products to control price increases and excessive spending.
All skin substitute products will be subject to the same coverage criteria, making it easier for doctors to select the best treatment option for patients.
The new payment rules take effect on January 1, 2026, with annual adjustments based on inflation starting in 2027.
Introduced
Additional Information
Print number: 119_S_2561
Sponsor: Sen. Cassidy, Bill [R-LA]
Process start date: 2025-07-31