Legalizing Premium Health Care Act of 2026

Summary

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.

Summary from the Congressional Research Service. How we handle summaries

Where it stands

Assigned to a committee for review.

Senate Committee on Finance · U.S. Senate

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Cosponsors

Full history

1. May 20, 2026

   Introduced

   Introduced in U.S. Senate

   U.S. Senate

2. May 20, 2026

   Referred to committee

   Read twice and referred to the Committee on Finance.

3. May 20, 2026

   Referred to committee

   Read twice and referred to the Committee on Finance.

Read the record

• Read on Congress.gov (opens in a new tab) The official record on Congress.gov.