WAYS AND MEANS COMMITTEE CONTINUES TO EXPAND HEALTH CARE ACCESS FOR SENIORS IN RURAL AND UNDERSERVED AREAS

The following information was released by the Committee on Ways and Means:

Committee-approved bills expand Medicare coverage to tests and treatments administered by local pharmacists and new home dialysis supports, independent physicians will benefit from stabilized Medicare reimbursement.

WASHINGTON, D.C.The Ways and Means Committee advanced bipartisan legislation to expand access to health care for seniors on Medicare, particularly those in rural and underserved communities, and to reauthorize Social Security's authority to test new approaches of connecting disability insurance beneficiaries to work.

Pharmacists will be allowed to receive Medicare reimbursement for administering tests and treatments for common respiratory illnesses.

The Medicare Physician Fee Schedule will be modernized to ensure predictable Medicare reimbursement for independent physicians.

Home dialysis patients will receive staff-assisted home dialysis and renal mental health services, equalizing access to support services between home and clinic settings.

The Social Security Administration's authority to test different program rules designed to promote attachment to the labor force and improve work outcomes for those receiving disability benefits will be reauthorized for five years.

Ways and Means Committee Chairman Jason Smith (MO-08)issued the following statement celebrating the committee passage of legislation expanding access to health care:

"The Ways and Means Committee took action to expand access to health care, especially for Americans in rural and underserved areas, and to break down barriers to Americans with disabilities who are seeking work. There is a severe and worsening shortage of health care professionals, and this bipartisan legislation delivers more care to seniors in their homes and the communities where they live. Seniors will be able to get basic test and treatment services from their local pharmacists, receive in-home staff support for home dialysis, and continue to receive care from their local independent doctor."

The Committee additionally adopted the Committee's Views and Estimates for the fiscal year 2027 budget.

Background on legislation approved by the Ways and Means Committee

Main Street Pharmacy Access Act (H.R. 3164)

Pharmacists are often the frontline health care option for patients in rural and underserved areas.

90 percent of the U.S. population lives within 5 miles of a pharmacy.

Many pharmacists are licensed to provide medical services other than dispensing drugs, promoting collaboration in care delivery and chronic disease management.

8.6 percent increase in medication adherence for patients suffering from diabetes and hypertension due to pharmacist-partnered interventions.

30 percent increase in detection of harmful hormone levels in patients with chronic kidney disease due to physician-pharmacist collaboration.

75 percent reduction in the risk of a cardiac event for heart failure patients due to clinical pharmacists working in conjunction with cardiologists.

Pharmacists that were trained and licensed to test and treat seniors for Covid-19 during the public health emergency (PHE) were able to receive reimbursements from Medicare.

Medicare does not reimburse pharmacists for testing and treatment outside of a PHE.

This bill expands seniors' access to critical primary care services by providing Medicare reimbursement for pharmacist-administered tests and treatments for common respiratory illnesses like strep throat, influenza, and RSV.

Read a fact sheet on the billhere.

The bill passed the Committee by voice vote.

Provider Reimbursement Stability Act of 2026 (H.R. 8163)

The current Medicare Physician Fee Schedule (PFS) is especially harmful to independent medical practices that preserve patient choice and keep care costs low.

Physicians experienced a 33 percent reduction in Medicare payments since 2001.

53 percent of physicians said Medicare reimbursement cuts were a major factor in choosing to consolidate over remaining independent.

The PFS is subject to an artificially low "budget neutrality" threshold, ensuring that any policy change above the threshold results in cuts to Medicare reimbursement to physicians or other services.

CMS is notorious for incorrectly predicting the impact of their policy changes, resulting in large, unjustified, year-over-year payment cuts.

A new primary care code proposed in 2020 was overestimated by approximately $1 billion, resulting in a 10 percent decrease in Medicare reimbursement for physicians.

The bill improves and modernizes the PFS to promote payment stability for independent doctors and patient access to care.

Increases the budget-neutral payment threshold to present-day values from the level set in 1992 and indexes it to inflation.

Improves transparency and accountability by requiring CMS to compare policy change cost estimates with actual utilization data and provide correction adjustments if inaccurate cuts were made.

Provides payment predictability by barring CMS from making changes to the PFS that would result in year-to-year changes greater than 2.5 percent.

Read a fact sheet on the billhere.

The bill passed the Committee 44-0.

Improving Home Dialysis Act of 2026 (H.R. 8875)

Only 15 percent of End-Stage Renal Disease (ESRD) patients use home dialysis, though it has significant health benefits.

Home dialysis results in faster recovery after treatment with fewer side effects, improved cardiac status, and increased life expectancy.

While Medicare covers some support services to facilitate home dialysis care, Medicare does not reimburse for staff-assisted home dialysis or renal mental health support services for home dialysis patients.

Staff-assisted home dialysis offers education and assistance services from trained professionals to help ESRD patients engage in home dialysis.

Renal mental health professionals help ESRD patients navigate the logistical complexities and emotional toll of dialysis and promote kidney transplantation referrals.

The bill facilitates patient access to home dialysis by allowing Medicare to reimburse for staff-assisted home dialysis services and renal mental health support services.

Read a fact sheet on the billhere.

The bill passed the Committee 28-13.

Removing Barriers to Work for Disabled Americans Act (H.R. 8884)

Fewer than 1 percent of Social Security Disability Insurance (DI) beneficiaries leave the program each year due to work activity, despite 60 percent of beneficiaries reporting they are "work-oriented."

Fear of overpayments, benefit cliffs, and confusing program eligibility rules are major hurdles for beneficiaries looking to return to the workforce.

The Social Security Administration's (SSA) authority to conduct demonstration projects, which provides flexibility to test different program rules designed to promote attachment to the labor force and improve work outcomes, expired in 2022.

The bill reauthorizes demonstration authority for five years to allow SSA to test alternative policies to help promote work for those who are able.

Read a fact sheet on the billhere.

The bill passed the Committee 27-16.