What This Bill Does · Plain English
Summary · Congress.gov
Legalizing Premium Health Care Act of 2026 This bill allows any Medicare beneficiary to enter into a contract with an eligible professional, regardless of whether the professional is participating in Medicare, for any item or service covered by Medicare. Such beneficiaries may submit a claim for Medicare payment in the amount that would otherwise apply, except that, where the professional is considered to be non-participating, payment shall be made as if the professional were participating. An eligible professional is a physician, physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse-midwife, clinical social worker, clinical psychologist, registered dietitian or nutrition professional, physical or occupational therapist, qualified speech-language pathologist, or qualified audiologist. A Medicare beneficiary must agree in writing in such a contract to (1) pay the eligible professional for a Medicare-covered item or service; and (2) submit, in lieu of the eligible professional, a claim for Medicare payment. However, a beneficiary may negotiate, as a term of the contract, for the eligible professional to file such claims on the beneficiary's behalf. The bill preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.
Action Timeline
2026-05-20
Introduced in Senate
2026-05-20
Read twice and referred to the Committee on Finance.
Frequently Asked Questions
Did S.4583 pass?
S.4583 is still alive. Current stage: COMMITTEE. Pass likelihood: pending.
What does S.4583 do?
Legalizing Premium Health Care Act of 2026 This bill allows any Medicare beneficiary to enter into a contract with an eligible professional, regardless of whether the professional is participating in Medicare, for any item or service covered by Medicare. Such beneficiaries may submit a claim for Medicare payment in the amount that would otherwise apply, except that, where the professional is considered to be non-participating, payment shall be made as if the professional were participating. An eligible professional is a physician, physician assistant, nurse practitioner, clinical nurse special…
Who sponsored S.4583?
S.4583 was sponsored by Rand Paul (R-Kentucky).
Full Bill Text
Full text not yet indexed for this bill. Check Congress.gov for the official text.
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