Bill · S. 2561· Senate(119-S-2561)
Skin Substitute Access and Payment Reform Act of 2025
- Introduced
- 7/31/2025
- Last activity
- 7/31/2025 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Bill Cassidy
- Cosponsors
- - 0 - 2
- Introduced
- In Committee
What this bill would do
This bill, known as the "Skin Substitute Access and Payment Reform Act of 2025," aims to change how Medicare pays for skin substitute products. It seeks to reform the payment and coverage rules for these biological therapies used to treat chronic wounds. The bill proposes moving to a volume-weighted average payment amount for these products starting in 2026. It also directs the Secretary to create a new consolidated billing and payment code. These changes are intended to address pricing uncertainties and control rising Medicare expenditures.
Yes· 3 of 6
Does this reduce what the federal government spends?+5
The bill implements a volume-weighted average payment limit to contain rising Medicare expenditures for skin substitute products.
Would people over 65 be better off under this?+3
The bill protects access to essential wound care treatments by preventing arbitrary denials of 'reasonable and necessary' coverage.
Would retired people be better off under this?+3
The bill aims to ensure consistent access to skin substitute treatments which are vital for treating chronic wounds in older populations.
The opposite
Does this put more money into Medicare, the health coverage for people over 65?-2
The bill shifts payment structures toward a volume-weighted average to contain costs, which may reduce total expenditure growth.
Who it would affect, and how
Potential Positive Impacts for People
-
Improved Health Outcomes: The use of skin substitute products can improve healing rates and reduce the rate of lower limb amputations for Medicare beneficiaries (Section 2, paragraph 1).
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Standardized Treatment Criteria: The bill ensures that all skin substitute products are subject to the same criteria when determining if they are "reasonable and necessary" for treatment, unless a product is deemed unsafe (Section 3, subsection b, paragraph (iii)(I)).
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Protection Against Arbitrary Denials: The Secretary is prohibited from determining that a product is not "reasonable and necessary" based solely on an analysis of its clinical evidence (Section 3, subsection b, paragraph (iii)(II)).
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Cost Containment: The reform aims to contain costs by addressing a system that currently incentivizes the use of more expensive products (Section 2, paragraph 4).
Potential Negative Impacts for People
-
Reduced Payment Amounts: The bill moves toward a volume-weighted average payment limit, which is intended to contain costs for Medicare expenditures (Section 3, subsection a).
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Price Adjustments: Starting in 2027, payment amounts will be adjusted annually based on the percentage increase in the consumer price index (Section 3, subsection a, paragraph (9)(C)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+3Good For Seniors+3Good For Low Income Households+1
- Economy And Finance
- Reduces Government Spending+5
- Healthcare
- Improves Healthcare Access+3Increases Medicare Funding-2
- Social Issues And Justice
- Improves Poverty Reduction+1
- 10/28/2025
- 1 Cosponsor added.
- 9/17/2025
- 1 Cosponsor added.
- 7/31/2025
- Read twice and referred to the Committee on Finance.
- Introduced in Senate
Cory BookerDemocrat · New Jersey
Maggie HassanDemocrat · New Hampshire