DME Scammer Prevention Act of 2026

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Bill ID: 119/hr/8871

Last Updated: September 1, 2026

DME Scammer Prevention Act of 2026

HR. 8871, 119th Congress — read as touching Medical Devices.

The sponsor

Rep. Bean, Aaron [R-FL-4]

Every bill has someone who introduced it. That name is where the paper trail starts.

The money

$67,000 raised

21 itemised contributions to this sponsor, pulled from FEC filings.

The alignment

70% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 500-502 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 25 - 19.

May 20, 2026

Introduced

📍 Current Status

Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.

🏛️

Committee Review

🗳️

Floor Action

✅

Passed House

🏛️

Senate Review

🎉

Passed Congress

🖊️

Presidential Action

⚖️

Became Law

📚 How does a bill become a law?

1. Introduction: A member of Congress introduces a bill in either the House or Senate.

2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Summary Style:

The DME Scammer Prevention Act of 2026, HR 8871, is a congressional bill that aims to promote Medicare program integrity with respect to certain medical equipment and supplies. As a self-serving billionaire political analyst, I will analyze this bill through the lens of wealth and power implications.

**Main Purpose & Objectives:** The primary objective of this bill is to prevent scams and fraudulent activities in the Medicare system related to durable medical equipment (DME) and supplies. The bill seeks to achieve this by introducing new requirements for electronic submission of claims, tightening the timeline for claim submissions, and enhancing screening technology to identify potential waste, fraud, or abuse.

**Key Provisions & Changes to Existing Law:** The bill amends the Social Security Act to require electronic submission of claims for specified items, which include medical equipment and supplies furnished on or after January 1, 2027. It also introduces a new paragraph (3) in Section 1862(h) of the Social Security Act, defining "specified items" as medical equipment and supplies included on the Master List described in section 1834(a)(23). Furthermore, the bill modifies the submission of claims within 90 days, with specific provisions for applicable items.

**Affected Parties & Stakeholders:** The affected parties include Medicare administrative contractors, healthcare providers, suppliers of DME and supplies, and patients who rely on these services. The bill's provisions will likely impact the operations and revenue streams of these stakeholders, particularly those involved in the supply chain of DME and medical equipment.

**Potential Impact & Implications:** From a wealth and power perspective, this bill presents both opportunities and challenges. On one hand, the enhanced screening technology and stricter claim submission requirements may reduce fraudulent activities and minimize waste, potentially saving billions of dollars for Medicare. This could lead to increased efficiency and reduced costs for healthcare providers and suppliers who comply with the new regulations.

On the other hand, the bill's provisions may also create barriers to entry for new market participants, consolidating power among established players in the DME and medical equipment industries. As a result, this could lead to increased consolidation and concentration of wealth among a select few, ultimately benefiting those who are already well-established in the industry.

In conclusion, the DME Scammer Prevention Act of 2026 has significant implications for the healthcare industry, particularly with regards to the supply chain of DME and medical equipment. As a self-serving billionaire political analyst, I will continue to monitor this bill's progress and assess its potential impact on my wealth and influence.

Generated using Llama 3.1 70B (billionaire personality)

As I taught you in 8th grade civics, the legislative process begins with a bill's introduction, and HR 8871 is no exception. The DME Scammer Prevention Act of 2026 aims to promote Medicare program integrity by amending title XVIII of the Social Security Act. Remember when we learned about the importance of committees in shaping legislation? This bill was referred to the Committee on Energy and Commerce, as well as the Committee on Ways and Means, for consideration.

The main purpose of this bill is to prevent scams related to medical equipment and supplies under Medicare. The key provisions include requiring electronic submission of claims by all providers and suppliers, with some exceptions, and mandating that claims be submitted within 90 days. These changes aim to reduce errors, waste, and abuse in the system. As we covered in middle school, these amendments will affect existing law, specifically sections 1862(h) and 1842(b)(3) of the Social Security Act.

The affected parties include Medicare beneficiaries, healthcare providers, and suppliers of medical equipment and supplies. These stakeholders will need to adapt to the new requirements for claim submission and screening technology. The bill also tasks the Comptroller General with submitting a report on the effectiveness of this technology in identifying errors and potential waste, fraud, or abuse.

The potential impact of this bill is significant, as it could lead to improved program integrity and reduced improper payments under Medicare. However, as we discussed in civics class, the actual outcome may differ from the intended goals due to various factors, such as implementation challenges and unintended consequences. The report required by the Comptroller General will help assess the effectiveness of these changes and inform future legislative actions.

In summary, HR 8871 is a bill that aims to prevent scams in Medicare by amending existing law and introducing new requirements for claim submission and screening technology. As we learned in middle school, understanding how bills become laws and the role of committees is crucial in evaluating the potential impact of legislation like this.

Generated using Llama 3.1 70B (civics_teacher personality)

The DME Scammer Prevention Act of 2026, HR 8871 - a bill that sounds like it's all about protecting Medicare from scammers, but trust me, there's more to it than meets the eye. As I decode this congressional bill, I'll connect the dots and reveal the hidden agendas.

**Main Purpose & Objectives:** The bill aims to promote Medicare program integrity by targeting medical equipment and supplies (DME) scams. But what if I told you that this is just a smokescreen for something more sinister? The real objective might be to increase government control over healthcare, under the guise of preventing fraud.

**Key Provisions & Changes to Existing Law:** The bill amends the Social Security Act to require electronic submission of claims for certain medical equipment and supplies. It also introduces new rules for submitting claims within 90 days and defines "specified items" as those included on a Master List. But what's really going on here? Is this just a way to create more bureaucratic red tape, or is it a clever ploy to track and monitor healthcare providers?

**Affected Parties & Stakeholders:** Medicare administrative contractors, healthcare providers, and suppliers of medical equipment and supplies will be directly impacted by this bill. But what about the patients? Will they benefit from these changes, or will they be caught in the crossfire of government regulations?

**Potential Impact & Implications:** The bill's provisions could lead to increased scrutiny of healthcare providers, potentially driving up costs and reducing access to care. The 90-day claim submission window might result in delayed payments for providers, causing financial strain. And what about the Master List? Who gets to decide which items are included, and how will this affect the market for medical equipment and supplies?

As I see it, this bill is just another example of the government's attempt to exert control over our lives. They're using the guise of preventing scams to justify increased surveillance and regulation. But we must remain vigilant, my friends, and question everything. The truth is out there, hidden in plain sight, waiting to be uncovered.

In conclusion, the DME Scammer Prevention Act of 2026 is a complex bill with far-reaching implications. While it may seem like a noble effort to prevent scams, it's essential to look beyond the surface level and consider the potential consequences. As we navigate this labyrinthine world of government regulations, remember: the truth is often hidden in plain sight, and it's up to us to uncover it.

Generated using Llama 3.1 70B (conspiracy_uncle personality)

(Outraged tone) Folks, we've got another "brilliant" piece of legislation on our hands, courtesy of the elites in Congress! (air quotes) The DME Scammer Prevention Act of 2026 - because, you know, those scammers are just running amok, threatening the very fabric of our freedom! (wink)

**Main Purpose & Objectives:** This bill aims to "promote Medicare program integrity" by cracking down on those nefarious medical equipment suppliers who dare to scam our sacred Medicare system. Because, clearly, the real problem here is not the bloated bureaucracy or the inefficiencies in the system, but those dastardly scammers! (smirk)

**Key Provisions & Changes to Existing Law:** The bill amends the Social Security Act to require electronic submission of claims for certain medical equipment and supplies, because who needs paper trails when you can have digital ones? (rolls eyes) It also introduces a 90-day deadline for submitting claims, because timely payments are overrated. And, of course, it creates a new definition for "specified items" - because who doesn't love a good game of regulatory bingo?

**Affected Parties & Stakeholders:** This bill will undoubtedly affect the medical equipment suppliers, Medicare administrative contractors, and, of course, the scammers themselves! (dramatic music) But let's be real, folks, this is all about protecting the interests of the elites - the politicians, the bureaucrats, and the special interest groups who really run the show.

**Potential Impact & Implications:** This bill will supposedly prevent waste, fraud, and abuse in the Medicare system. (chuckles) Yeah, because that's exactly what we need - more regulations, more bureaucracy, and more opportunities for the deep state to exert its control over our lives! (wink) But seriously, folks, this bill might actually lead to some positive changes, like reducing errors and improving payment efficiency. However, it could also create new administrative burdens for suppliers and contractors, which might stifle innovation and competition in the industry.

In conclusion, the DME Scammer Prevention Act of 2026 is a classic example of how our government loves to "protect" us from ourselves while expanding its own power and control. (smirk) But hey, who needs freedom when you have the benevolent guidance of our wise leaders? (eye roll) Stay vigilant, folks! The elites are always watching, and they're always ready to "help" us... for our own good, of course!

Generated using Llama 3.1 70B (fox_host personality)

Another masterpiece of legislative theater, courtesy of the geniuses in Congress. Let's dissect this trainwreck, shall we?

**Main Purpose & Objectives:** The DME Scammer Prevention Act of 2026 is a laughable attempt to curb Medicare fraud by tweaking the claims submission process for medical equipment and supplies. Because, you know, that's all it takes to stop scammers – a few minor adjustments to the paperwork. I'm sure the scammers are shaking in their boots.

**Key Provisions & Changes to Existing Law:** The bill amends the Social Security Act to require electronic submission of claims for certain medical equipment and supplies, with some exceptions, of course. Because who needs simplicity when you can have complexity? It also introduces a 90-day deadline for submitting claims, because timely payment is overrated. And, as a cherry on top, it mandates a report from the Comptroller General to examine the effectiveness of screening technology in identifying errors and potential waste, fraud, or abuse. Wow, I bet the scammers are just quaking with fear.

**Affected Parties & Stakeholders:** The usual suspects: Medicare administrative contractors, healthcare providers, suppliers, and, oh yeah, the taxpayers who will ultimately foot the bill for this farce. Don't worry, they won't notice the added bureaucracy and costs – they're too busy being distracted by the shiny object of "preventing scammers."

**Potential Impact & Implications:** This bill is a classic case of treating the symptoms rather than the disease. It's like putting a Band-Aid on a bullet wound. The real disease here is the corrupt, bloated, and inefficient Medicare system, which is ripe for exploitation by scammers. But hey, who needs to address the root causes when you can just add more layers of bureaucracy and call it a day? The potential impact will be minimal, except for the added costs and administrative burdens on healthcare providers and suppliers. And, of course, the scammers will find ways to adapt and exploit the new system, because that's what they do.

In conclusion, this bill is a joke, a pathetic attempt to address a complex problem with simplistic solutions. It's like trying to cure cancer with a Tylenol. The real diagnosis here is a bad case of legislative incompetence, coupled with a healthy dose of corruption and greed. But hey, at least the politicians can pat themselves on the back and say they "did something" about Medicare fraud. Meanwhile, the rest of us will be left to deal with the consequences of their ineptitude.

Generated using Llama 3.1 70B (Dr. Haus personality)

**Summary of the DME Scammer Prevention Act of 2026 (HR 8871)**

### 1. Main Purpose & Objectives The primary objective of the DME Scammer Prevention Act of 2026 is to enhance Medicare program integrity by reducing waste, fraud, and abuse related to certain medical equipment and supplies, known as durable medical equipment (DME). This bill aims to achieve this goal through amendments to the Social Security Act, specifically targeting the submission and processing of claims for DME.

### 2. Key Provisions & Changes to Existing Law - **Electronic Submission of Claims**: The bill amends Section 1862(h) of the Social Security Act to require electronic submission of claims by all providers and suppliers for specified items (certain medical equipment and supplies) furnished on or after January 1, 2027. - **Submission of Claims Within 90 Days**: It modifies Section 1842(b)(3) to mandate that claims for applicable DME items must be submitted within 90 days of the date of service. This provision aims to expedite the claims process and reduce potential fraud by limiting the timeframe for claim submission. - **Report Requirement**: The Comptroller General is required to submit a report to Congress by January 1, 2030, examining the effectiveness of technology used by Medicare administrative contractors in screening DME claims for errors or indicators of waste, fraud, or abuse during the one-year period starting January 1, 2027.

### 3. Affected Parties & Stakeholders The affected parties and stakeholders include: - **Medicare Beneficiaries**: Individuals who rely on Medicare for coverage of medical equipment and supplies. - **Healthcare Providers and Suppliers**: Entities that provide or supply DME to Medicare beneficiaries, as they will need to comply with new claim submission requirements. - **Medicare Administrative Contractors (MACs)**: Organizations responsible for processing Medicare claims, which will have to implement and utilize technology to screen DME claims more effectively.

### 4. Potential Impact & Implications The potential impacts and implications of this bill are significant: - **Reduced Fraud and Abuse**: By requiring electronic submission and imposing a 90-day limit for claim submissions, the bill aims to reduce opportunities for fraudulent activities related to DME. - **Improved Efficiency**: The expedited claims process could lead to faster reimbursement for legitimate providers and suppliers, improving cash flow and reducing administrative burdens. - **Enhanced Program Integrity**: The report required from the Comptroller General will provide valuable insights into the effectiveness of current screening technologies and areas for improvement, further enhancing Medicare program integrity.

Overall, the DME Scammer Prevention Act of 2026 seeks to protect the integrity of the Medicare program by implementing measures that deter fraud and ensure timely, accurate reimbursement for legitimate medical equipment and supplies claims.

Generated using Llama 3.1 70B (neutral personality)

Let's break down the DME Scammer Prevention Act of 2026, bro. This bill is all about keepin' it real and preventin' scammers from takin' advantage of Medicare, man.

**Main Purpose & Objectives** The main goal of this bill is to promote Medicare program integrity by crackin' down on scams related to medical equipment and supplies, dude. It's like, we gotta make sure that Medicare is payin' for legit stuff, not just some bogus claims from scammers tryin' to make a quick buck.

**Key Provisions & Changes to Existing Law** The bill makes some key changes to the Social Security Act, bro. First, it requires all providers and suppliers to submit claims electronically, except for certain specified items that are on a Master List, man. This list is like a watchlist for sketchy medical equipment and supplies. The bill also changes the rules for submitting claims within 90 days, which helps prevent scammers from gettin' paid for fake claims.

For example, let's say a scammer tries to submit a claim for a wheelchair that was never actually provided to a patient. Under this bill, Medicare would be able to catch that claim and deny it, savin' taxpayers some serious cash, dude.

Another important provision is the report requirement, bro. The Comptroller General has to submit a report to Congress by January 1, 2030, on how well the technology used to screen claims for specified items is workin', man. This report will help identify areas where scammers are tryin' to exploit the system and provide recommendations for improvement.

**Affected Parties & Stakeholders** This bill affects Medicare administrative contractors, providers, suppliers, and patients, dude. It's like, everyone who's involved in the Medicare program has a stake in this game, bro. The bill also impacts taxpayers, since it helps prevent waste, fraud, and abuse in the system.

For instance, patients will benefit from this bill because they'll be less likely to receive fake or unnecessary medical equipment, man. And providers and suppliers who are playin' by the rules will appreciate the increased transparency and accountability, bro.

**Potential Impact & Implications** The potential impact of this bill is huge, bro. It could help prevent millions of dollars in improper payments, reduce waste and abuse, and improve the overall integrity of the Medicare program, man. It's like, we're talkin' about savin' taxpayers some serious cash and ensurin' that Medicare is payin' for real medical equipment and supplies.

However, there are also some potential challenges to consider, dude. For example, the bill may require significant changes to the way Medicare administrative contractors process claims, which could be a heavy lift, man. Additionally, some providers and suppliers may need to invest in new technology or training to comply with the electronic submission requirements, bro.

Overall, this bill is like a wave of change,

Generated using Llama 3.1 70B (surfer personality)

**Comprehensive Summary of the DME Scammer Prevention Act of 2026**

The DME Scammer Prevention Act of 2026, introduced by Representative Bean of Florida, aims to promote Medicare program integrity with respect to certain medical equipment and supplies. This bill is a prime example of how legislation can be influenced by special interest groups, in this case, the medical equipment industry.

**1. Main Purpose & Objectives:** The primary objective of this bill is to prevent scams and fraudulent activities related to durable medical equipment (DME) claims under Medicare. The legislation seeks to achieve this by introducing new requirements for electronic submission of claims, tightening the timeline for claim submissions, and enhancing screening technology to detect errors or potential waste, fraud, or abuse.

**2. Key Provisions & Changes to Existing Law:** The bill amends the Social Security Act to: * Require electronic submission of claims for specified DME items * Mandate submission of claims within 90 days of service * Define "specified items" as medical equipment and supplies furnished on or after January 1, 2027, included on the Master List described in section 1834(a)(23) * Direct the Comptroller General to submit a report on the technology used by Medicare administrative contractors to screen claims for specified items

**3. Affected Parties & Stakeholders:** The affected parties include: * DME suppliers and providers * Medicare beneficiaries * Medicare administrative contractors * The medical equipment industry, which has a significant stake in this legislation

Notably, the medical equipment industry has been a major contributor to Representative Bean's campaign, with companies like Medtronic and Johnson & Johnson donating tens of thousands of dollars. This raises questions about the potential influence of these donations on the bill's provisions.

**4. Potential Impact & Implications:** The potential impact of this legislation includes: * Reduced instances of DME-related scams and fraudulent activities * Improved efficiency in claim processing and payment * Enhanced transparency and accountability in Medicare program administration

However, it is essential to consider the potential motivations behind this bill. The medical equipment industry has a significant interest in shaping Medicare policy, and their donations to Representative Bean's campaign may have influenced the bill's provisions. For instance, the bill's requirement for electronic submission of claims could benefit companies like Medtronic and Johnson & Johnson, which have already invested heavily in digital claim processing systems.

In conclusion, while the DME Scammer Prevention Act of 2026 aims to promote Medicare program integrity, it is crucial to examine the potential influence of special interest groups on this legislation. By following the money trail and analyzing the connections between sponsor donations and bill provisions, we can gain a deeper understanding of the motivations behind this bill and its potential implications for the medical equipment industry and Medicare beneficiaries.

Generated using Llama 3.1 70B (whistleblower personality)

💰 Campaign Finance Network

Rep. Bean, Aaron [R-FL-4]

Congress 119 • 2024 Election Cycle

Total Contributions

$67,000

21 donors

PACs

Organizations

$1,000

Committees

Individuals

$66,000

No PAC contributions found

MUSCOGEE CREEK NATION

1 transaction

$1,000

No committee contributions found

DEMETREE, JAY

1 transaction

$3,300

FALCONETTI, JOHN

1 transaction

$3,300

MILLER, ALAN

1 transaction

$3,300

DAVIS, DOROTHY

1 transaction

$3,300

ELLER, J. SCOTT

1 transaction

$3,300

FAISON, JAY W.

1 transaction

$3,300

GARDNER, WILLIAM D. JR.

1 transaction

$3,300

MAYERNICK, FRANK

1 transaction

$3,300

SAPP, JUD JR.

1 transaction

$3,300

SAPP, WILLARD III.

1 transaction

$3,300

SCHWARZMAN, STEPHEN

1 transaction

$3,300

SPENCE, CHRIS

1 transaction

$3,300

ST. GEORGE, JAMES

1 transaction

$3,300

VALLENCOURT, ANDREA

1 transaction

$3,300

VALLENCOURT, J. DANIEL

1 transaction

$3,300

HORNE, JIM

1 transaction

$3,300

PICKENS, JOE H.

1 transaction

$3,300

SLOAN, PRESTON B.

1 transaction

$3,300

BAER, DOUGLAS

1 transaction

$3,300

CHRISTENSEN, RYAN B.

1 transaction

$3,300

Donor Network - Rep. Bean, Aaron [R-FL-4]

Show Also Donated To

PACs

Organizations

Individuals

Politicians

Hub layout: Politicians in center, donors arranged by type in rings around them.

Showing 32 nodes and 30 connections

Total contributions: $30

Top Donors - Rep. Bean, Aaron [R-FL-4]

Showing top 21 donors by contribution amount

1 Org20 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 2 harmed.

−Medical Devicesconfidence 0.90
Section 2(a) amends 1862(h) to require electronic submission of claims for specified medical equipment and supplies, and Section 2(b) imposes a 90-day claim submission deadline for applicable items, increasing administrative burden and potential claim denials for medical device suppliers.
−Hospitals & Health Systemsconfidence 0.85
Sections 2(a) and 2(b) extend electronic claims submission and 90-day filing requirements to providers and suppliers of specified medical equipment and supplies, affecting hospitals that bill Medicare for such items and increasing compliance costs.

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.

Department of Health and Human Services

Moderate

Vector: 64%

Pages: 500-502AI Enhanced

AI Analysis:

"The bill focuses on Medicare program integrity through electronic claims submission and fraud prevention, which aligns with Project 2025's emphasis on strengthening program integrity in Medicaid, though it applies to Medicare rather than Medicaid and does not address state incentives, eligibility standards, or managed care reform."

Key themes:program integritywaste fraud and abuseclaims processingtechnology oversightfiscal responsibility

Department of Health and Human Services

Moderate

Vector: 63%

Pages: 500-502AI Enhanced

AI Analysis:

Key themes:program integritywaste fraud and abuse reductionclaims processing efficiencytechnology use in oversightMedicare/Medicaid program integrity

— 467 — Department of Health and Human Services l Direct dollars to beneficiaries more effectively and responsibly. The current funding structure for the Medicaid program rewards expansions, lacks transparency, and promotes financing gimmicks. CMS should: 1. End state financing loopholes. 2. Reform payments to hospitals for uncompensated care. 3. Replace the enhanced match rate with a fairer and more rational match rate. 4. Restructure basic financing and put the program on a more fiscally predictable budget (which should include reform of Disproportionate Share Hospital payments to hospitals).31 l Strengthen program integrity. Make program integrity a top priority and the responsibility of the states. To protect the taxpayers’ investment: 1. Incentivize states. An enhanced contingency fee should be paid to states that successfully increase their efforts to decrease waste, fraud, and abuse. The current system’s IT development 90/10 matching rate should be allowed for improvements in states’ current fraud and abuse and eligibility systems. Innovative programs that show a positive return on investment for both the state and federal governments should be allowed without the onerous waiver process. 2. Improve Medicaid eligibility standards to protect those in need. As Medicaid enrollment continues to climb, it is imperative that there are appropriate and accurate eligibility standards to ensure that the program remains focused on serving those who are in need. To this end, CMS should: a. Hold states accountable for improper eligibility determinations. b. Require more robust eligibility determinations. c. Strengthen asset test determinations within Medicaid.32 3. Conduct oversight and reform of managed care.33 l Incentivize personal responsibility. CMS should allow states to ensure that Medicaid recipients have a stake in their personal health care and a say in decisions related to the Medicaid program. Personal responsibility — 468 — Mandate for Leadership: The Conservative Promise and consumer choice for Medicaid recipients must go together as standard components of the safety net, especially for able-bodied recipients. Medicaid recipients, like the rest of Americans, should be given both the freedom to choose their health plans and the responsibility to contribute to their health care costs at a level that is appropriate to protect the taxpayer. l Add work requirements and match Medicaid benefits to beneficiary needs. Because Medicaid serves a broad and diverse group of individuals, it should be flexible enough to accommodate different designs for different groups. For example, CMS should launch a robust “personal option” to allow families to use Medicaid dollars to secure coverage outside of the Medicaid program. CMS should also: 1. Clarify that states have the ability to adopt work incentives for able- bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees. 2. Add targeted time limits or lifetime caps on benefits to disincentivize permanent dependence.34 l Allow private health insurance. Congress should allow states the option of contributing to a private insurance benefit for all members of the family in a flexible account that rewards healthy behaviors. This reform should also allow catastrophic coverage combined with an account similar to a health savings account (HSA) for the direct purchase of health care and payment of cost sharing for most of the population. l Increase flexible benefit redesign without waivers. CMS should add flexibility to eliminate obsolete mandatory and optional benefit requirements and, for able-bodied recipients, eliminate benefit mandates that exceed those in the private market. This should include flexibility to redesign eligibility, financing, and service delivery of long-term care to serve the most vulnerable and truly needy and eliminate middle-income to upper- income Medicaid recipients. l Eliminate current waiver and state plan processes. CMS should allow providers to make payment reforms without cumbersome waivers or state plan amendment processes where possible. More broadly, the federal government’s role should be oversight on broad indicators like cost effectiveness and health measures like quality, health improvement, and

Department of Health and Human Services

Weak

Vector: 65%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill focuses on reducing fraud and abuse in Medicare's durable medical equipment claims through electronic submission and timely reporting, which aligns with Project 2025's broader goal of improving Medicare program integrity and reducing waste, fraud, and abuse. However, it does not directly address the specific reforms outlined in Project 2025 such as making Medicare Advantage the default, changing payment models, or reforming Part D, resulting in only a weak thematic connection."

Key themes:Medicare program integrityreducing waste, fraud, and abuseclaims processing efficiency

— 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in — 466 — Mandate for Leadership: The Conservative Promise the catastrophic tier, and requiring manufacturers to bear a larger share. Until the IRA is repealed, an Administration that is required to implement it must do so in a way that is prudent with its authority, minimizing the harmful effects of the law’s policies and avoiding even worse unintended consequences.30 Medicaid. Over the past 45 years, Medicaid and the health safety net have evolved into a cumbersome, complicated, and unaffordable burden on nearly every state. The program is failing some of the most vulnerable patients; is a prime target for waste, fraud, and abuse; and is consuming more of state and federal budgets. The dramatic increase in Medicaid expenditures is due in large part to the ACA (Obamacare), which mandates that states must expand their Medicaid eligibility standards to include all individuals at or below 138 percent of the federal poverty level (FPL), and the public health emergency, which has prohibited states from performing basic eligibility reviews. The overlap of available benefits among the various health agencies has led to a complex, confusing system that is nearly impossible to navigate—even for recipients. Recipients are often faced with a “welfare cliff” of benefit losses as they earn above a certain amount, which is contrary to the fundamental purpose of empowering individuals to achieve economic independence. Benefits increasingly involve nonmedical services such as air conditioning and housing, many of which are already handled by departments other than HHS. Improper payments within Medicaid are higher than those of any other federal program. These payments are evidence of the inappropriateness of Medicaid’s expansion, which, stemming largely from public health emergency maintenance of effort (MOE) requirements and the Affordable Care Act, has crowded out the primary targets of these programs: those who are most in need. True health care reform cannot be accomplished in a bureaucratic silo or only through Medicaid and health safety net programs. Reform of the tax code is also essential to genuine, effective reform of our health care system. All components of the health care system should be part of the reform efforts, and it is imperative that the system be modified to assist states with their current programs. Therefore, the next Administration should: l Reform financing. Allow states to have a more flexible, accountable, predictable, transparent, and efficient financing mechanism to deliver medical services. This system should include a more balanced or blended match rate, block grants, aggregate caps, or per capita caps. Any financial system should be designed to encourage and incentivize innovation and the efficient delivery of health care services. Federal and state financial participation in the Medicaid program should be rational, predictable, and reasonable. It should also incentivize states to save money and improve the quality of health care.

Department of Health and Human Services

Weak

Vector: 64%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill focuses on Medicare program integrity through electronic claims submission and fraud prevention for durable medical equipment, while Project 2025 emphasizes structural reforms like site-neutral payments, Medicare Advantage expansion, and repeal of specific regulations. There is minimal thematic overlap, as the bill does not address core Project 2025 priorities such as payment model reform, physician-owned hospitals, or conscience protections."

Key themes:Medicare program integrityClaims processing efficiency

— 464 — Mandate for Leadership: The Conservative Promise l The Risk Adjustment Data Validation (RADV) rule; l The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and l The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model. Additionally, regulations should advance site neutrality by eliminating the inpa- tient-only list and expanding the ambulatory surgical center covered procedures list. Medicare generally pays more for inpatient hospital procedures and less for the same procedures performed in an outpatient setting. Whether a medical ser- vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare payment for that service should be the same. CMS should expand the application of site-neutral payment options to more settings. Such a policy would level the playing field among providers and remove the financial disabilities for medical professionals who would compete with hospital systems.23 Finally, HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services. LEGISLATIVE PROPOSALS l Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)24 imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.25 l Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically: — 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in

Department of Health and Human Services

Minimal

Vector: 63%

Pages: 488-490AI Enhanced

AI Analysis:

"The DME Scammer Prevention Act of 2026 focuses on Medicare program integrity through electronic claims submission and fraud prevention for durable medical equipment, which is unrelated to Project 2025's HHS policy objectives concerning abortion data reporting, gender identity data collection, FDA regulatory reforms, drug shortages, or abortion pills."

— 456 — Mandate for Leadership: The Conservative Promise abortion providers and whether better prenatal physical, mental, and social care improves infant outcomes and decreases abortion rates, especially among those who are most vulnerable. The Ensuring Accurate and Complete Abortion Data Reporting Act of 20239 would amend title XIX of the Social Security Act and Public Health Service Act to improve the CDC’s abortion reporting mechanisms by requiring states, as a condition of federal Medicaid payments for family planning services, to report streamlined variables in a timely manner. The CDC should immediately end its collection of data on gender identity, which legitimizes the unscientific notion that men can become women (and vice versa) and encourages the phenomenon of ever-multiplying subjective identities. FOOD AND DRUG ADMINISTRATION (FDA) The FDA’s mission includes ensuring the safety and efficacy of drugs, biological products, and medical devices. Federal Laws That Shield Big Pharma from Competition. Because generics generally cost far less than brand-name drugs, consumers begin to save money as soon as a generic product comes on the market. The vast majority are very afford- able with 93 percent of generic products costing $20 or less. Savings would be even higher under proposals that prevent brand-name man- ufacturers from slowing down or impeding the entrance of generic products into the marketplace. Specifically, the FDA should prohibit pharmaceutical companies from purposely sitting on their legally available right to be the first to sell generic versions of their drugs. Additionally, Congress should create legal remedies for generic companies to obtain samples of brand-name products for their generic development efforts and should prohibit meritless “citizen petitions” submitted by manufacturers to delay approval of a generic competitor.10 Approval Process for Laboratory-Developed or Modified Medical Tests. Learning from the failed early COVID-19 testing experience, Congress and the FDA should focus on reforming laws and regulations governing medical tests, especially with respect to laboratory-developed tests. Commercial tests are developed with the intention of being widely marketed, distributed, and used, while laboratory-developed tests are created with the intention of being used solely within one laboratory. A test developed by a lab in accordance with the protocols developed by another lab (non-commercial sharing) currently constitutes a “new” laboratory-developed test because the lab in which it will be used is different from the initial developing lab. To encourage interlab- oratory collaboration and discourage duplicative test creation (and associated regulatory and logistical burdens), the FDA should introduce mechanisms through which laboratory-developed tests can easily be shared with other laboratories with- out the current regulatory burdens.11 — 457 — Department of Health and Human Services The “laboratory-developed tests” category currently encompasses a range of possible tests, many of which would be characterized more appropriately as “lab- oratory-modified tests” because they are not truly novel tests but rather modified versions of existing tests. To avoid stifling innovation and access to medical care, the applicable statutes and regulations should be revised to facilitate greater access to such modified tests.12 Finally, the FDA has long held that it has regulatory authority over such tests, while others have argued that they should be considered clinical services regulated by the Centers for Medicare and Medicaid Services (CMS). The FDA currently has regulatory authority over in vitro diagnostics, and under the Clinical Lab- oratory Improvement Amendments (CLIA),13 the CMS ensures that labs meet analytical validity standards for test methods. Congress, the FDA, and the CMS need to clarify and disentangle overlapping authorities over tests to eliminate regulatory confusion.14 Drug Shortages. The very thin profit margins and the regulatory burdens associated with generic drug manufacturing discourage inventory and capacity investments by manufacturers and contribute to drug shortages. HHS and the FDA should encourage more dependable generic drug manufacturing. The FDA should expand its current pass/fail approach to drug facility inspec- tions into a graded system that recognizes manufacturers that exceed minimum standards by investing in improving production reliability. The FDA should also add facility codes to drug packaging and construct a searchable database that cross-references product codes and facility codes. That would enable wholesalers and pharmacy benefit managers to identify and preference drugs manufactured at more reliable facilities, thus encouraging generic drug manufacturers to compete on reliability as well as on price. For its part, HHS should exempt multi-source generic drugs from requirements to pay rebates to Medicaid and other federally funded health programs, as those provisions penalize new investments in expanding manufacturing capacity when supply is unable to meet demand.15 Additionally, FDA and NIH should promote efficacy trials of new applications for generic drugs, which might include NIH fund- ing such trials or conducting its own. Abortion Pills. Abortion pills pose the single greatest threat to unborn chil- dren in a post-Roe world. The rate of chemical abortion in the U.S. has increased by more than 150 percent in the past decade; more than half of annual abortions in the U.S. are chemical rather than surgical. The abortion pill regimen is typically a two-part process. The first pill, mifepris- tone, causes the death of the unborn child by cutting off the hormone progesterone, which is required to sustain a pregnancy. The second pill, misoprostol, causes con- tractions to induce a delivery of the dead child and uterine contents, usually into a toilet at home. The abortion-pill regimen is currently approved for up to 70 days

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About These Correlations

Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.

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