Bill · H.R. 9972· House(119-HR-9972)
American Patients First Act of 2026
- Introduced
- 7/27/2026
- Last activity
- 7/27/2026 — Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Sponsored by
- Pete Sessions
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
The American Patients First Act of 2026 aims to change how Medicare pays for skin substitute products. It sets a specific payment rate of $457 per square centimeter for these products between January 1, 2027, and December 31, 2030. The bill establishes strict domestic sourcing and distribution requirements for these products. It also introduces new oversight measures, including prepayment claim reviews and prior authorization for certain providers. Additionally, it creates rules regarding wound treatment, such as limitations on repeated applications and product wastage.
Yes· 3 of 5
Does this give the federal government more power?+5
The bill expands federal oversight of Medicare payments and provider compliance via prepayment reviews and prior authorization.
Would people over 65 be better off under this?+5
The bill standardizes Medicare coverage for skin substitute products, which may benefit older patients requiring wound care.
Would retired people be better off under this?+5
The bill ensures consistent Medicare coverage for essential skin substitute treatments.
The opposite
Would business owners be better off under this?-3
The bill imposes strict domestic sourcing, distribution, and certification requirements that may increase operational costs for businesses.
Who it would affect, and how
Potential Positive Impacts for People
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Domestic Product Standards: The bill requires that all human cellular or tissue material be donated by U.S. citizens or legal residents and that all manufacturing occurs exclusively within the United States (Section 2(c)(iii)).
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Protecting Patient Access: The Secretary has the authority to waive domestic sourcing requirements for up to 180 days if there is a domestic supply shortage to ensure patients can still get care (Section 2(c)(iii)(iv)).
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Preventing Abuse of Billing: The bill implements prepayment reviews and prior authorization to monitor "outlier providers" who receive high levels of payment, aimed at identifying potential fraud, waste, or abuse (Section 3(1)).
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Standardizing Coverage: For the year 2027, the bill prevents the Secretary or contractors from denying coverage based solely on an analysis of clinical evidence (Section 3(2)).
Potential Negative Impacts for People
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Increased Oversight Burdens: Certain providers may be subject to prepayment claim reviews and prior authorization requirements, which could impact how they provide care (Section 3(1)).
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Limitations on Treatment: Payment may be denied for more than three distinct applications of a skin substitute product on the same wound if there is no improvement (Section 3(4)).
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Wastage Restrictions: Medicare will only pay for a "reasonable and necessary" portion of the product, excluding any amount considered wastage (Section 3(3)).
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Provider Certification Requirements: To receive payment, providers must hold specific certifications from recognized boards, such as the American Board of Wound Management or the Wound, Ostomy and Continence Nursing Certification Board (Section 3(5)).
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Strict Sourcing Requirements: Products that do not meet the specific domestic sourcing, harvesting, and distribution rules may be excluded from coverage unless a waiver is granted (Section 2(c)(ii)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Governance And Ideology
- Increases Federal Power+5Improves Government Transparency+3
- Demographic And Interest Groups
- Good For Retirees+5Good For Seniors+5Good For Business Owners-3
- Healthcare
- Improves Healthcare Access+5
- 7/27/2026
- Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House