Bill · S. 4924· Senate(119-S-4924)
Preserving Patient Access Act
- Introduced
- 6/24/2026
- Last activity
- 6/24/2026 — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- Sponsored by
- Jacky Rosen
- Cosponsors
- - 0 - 1
- Introduced
- In Committee
What this bill would do
The Preserving Patient Access Act aims to protect access to healthcare providers and drug coverage under Medicare and individual market plans. For Medicare Advantage, it addresses instances where a provider becomes out-of-network after an individual has had an in-person or telehealth visit within the previous two years. The bill also addresses mid-year negative formulary changes for prescription drug plans. For individual market plans, it establishes a special enrollment period. This special period allows individuals to switch coverage if a provider becomes out-of-network or if a negative formulary change occurs. These changes are intended to apply to plan years beginning on or after January 1, 2027.
Yes· 3 of 6
Would people over 65 be better off under this?+5
The bill protects Medicare Advantage beneficiaries from losing access to established providers or drug coverage mid-year.
Would retired people be better off under this?+5
The bill ensures that retirees on Medicare can maintain continuity of care even if their providers or drug formularies change.
Does this make health care easier to get in general?+5
The bill enhances access by allowing patients to switch plans if their provider goes out-of-network or if drug coverage changes.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Maintaining Provider Access in Medicare: Under Section 2, subsection (a)(1)(D), a person can establish a connection through an in-person or telehealth visit within the preceding 2-year period. This helps when a provider who was in-network during the annual election period becomes an out-of-network provider.
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Addressing Drug Coverage Changes in Medicare: Section 2, subsection (a)(2)(F) addresses mid-year negative formulary changes for prescription drug plans or MA-PD plans. This applies when a plan implements a negative change for a drug that was provided within the previous 6-month period and still has active approval or licensure.
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Special Enrollment Opportunities for Individual Market Plans: Under Section 2, subsection (b)(1)(B)(i), individuals can utilize a special enrollment period to switch plans. This is available if a provider with whom they had an in-person or telehealth visit within the last 2 years becomes out-of-network, or if the plan implements a mid-year negative formulary change for a drug they were receiving.
Potential Negative Impacts for People
- No specific negative impacts or burdens are explicitly detailed within the provided text.
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+5Good For Seniors+5Good For Low Income Households+3
- Healthcare
- Improves Healthcare Access+5Increases Affordable Care Act Support+4Reduces Prescription Drug Costs+3
- 6/24/2026
- Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 1 Cosponsor added.
- Introduced in Senate
John CurtisRepublican · Utah