HR 307
ARC Act of 2025
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Bill overview
The Amputation Reduction and Compassion Act of 2025 (ARC Act) aims to reduce amputations, particularly among at-risk individuals, by expanding Medicare and Medicaid coverage for peripheral artery disease (PAD) screening tests. It requires the development of educational programs and quality measures to promote PAD awareness and preventative care. The bill also establishes a pilot program to encourage hospitals and clinics to implement amputation prevention strategies.
Key provisions
- Medicare and Medicaid will cover PAD screening tests for certain at-risk beneficiaries without cost-sharing.
- The Centers for Disease Control and Prevention will establish a PAD education program to raise awareness and promote preventative measures.
- Quality measures will be developed to encourage alternative treatments to amputation for PAD patients.
- The bill defines ‘at-risk beneficiary’ based on age, risk factors, and prior vascular disease.
- PAD screening tests are defined as ankle-brachial index testing, arterial duplex scans, and other appropriate services.
- The Secretary will establish standards for the frequency of PAD screening tests.
- A pilot program will be launched to test amputation prevention programs in hospitals and clinics.
- The bill includes provisions for incorporating PAD screening into preventive care and quality reporting programs.
Who is affected
- Individuals with diabetes
- Older adults (65+)
- Adults aged 50-64 with risk factors for atherosclerosis
Sponsors
Official sponsors from legislative records.
Primary sponsor
Cosponsors
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119th CONGRESS — 1st Session
H. R. 307
IN THE HOUSE OF REPRESENTATIVES
A BILL
To amend titles XVIII and XIX of the Social Security Act to provide for coverage of peripheral artery disease screening tests furnished to at-risk beneficiaries under the Medicare and Medicaid programs without the imposition of cost-sharing requirements, and for other purposes.
This Act may be cited as the Amputation Reduction and Compassion Act of 2025 ARC Act of 2025
or the
.
Congress makes the following findings:
Atherosclerosis occurs when blood flow is reduced because arteries become narrowed or blocked with fatty deposits.
Atherosclerosis is responsible for more deaths in the United States than any other condition, and heart attacks, resulting from clogged coronary arteries, are the leading cause of death in America.
Atherosclerosis also occurs in the legs and is known as peripheral artery disease (in this subsection referred to as PAD
) and having PAD significantly increases the risk for heart attack, stroke, amputation, and death.
While most Americans are aware of atherosclerosis in the heart, many Americans have never heard of PAD and Americans with PAD are often unaware of the serious risks of the disease.
An estimated 21 million Americans have PAD, and about 200,000 of them—disproportionately minorities—suffer avoidable amputations every year as a result of such disease.
According to the Dartmouth Atlas, amputation risks for African Americans living with diabetes are as much as four times higher than the national average.
Data analyses have similarly found that Native Americans are more than twice as likely to be subjected to amputation and Hispanics are up to 75 percent more likely to have an amputation.
Fifty-two percent of patients with an above-the-knee amputation and 33 percent of patients with a below-the-knee amputation will die within two years of their amputation.
Screening and arterial testing for PAD is cost-effective and should be part of routine medical care.
Once PAD is detected, amputations and deaths can be reduced through the use of national, evidence-based PAD care guidelines.
Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following new section:
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, in collaboration with the Administrator of the Centers for Medicare & Medicaid Services, the Administrator of the Health Resources and Services Administration, leading clinical and patient advocacy organizations, and other interested stakeholders shall establish and coordinate a peripheral artery disease education program to support, develop, and implement educational initiatives and outreach strategies that inform health care professionals and the public about the existence of peripheral artery disease and methods to reduce amputations related to such disease, particularly with respect to at-risk populations.
The Secretary shall, as appropriate, identify and disseminate to health care professionals best practices with respect to peripheral artery disease.
There is authorized to be appropriated to carry out this section $6,000,000 for each of fiscal years 2026 through 2030.
Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—
in subsection (s)(2)—
in subparagraph (JJ), by striking the semicolon at the end and inserting ; and
; and
by adding at the end the following new subparagraph:
by adding at the end the following new subsection:
noninvasive physiologic studies of extremity arteries (commonly referred to as ankle-brachial index testing);
who is 65 years of age or older;
who is at least 50 years of age but not older than 64 years of age with risk factors for atherosclerosis (such as diabetes mellitus, a history of smoking, hyperlipidemia, and hypertension) or a family history of peripheral artery disease;
who is younger than 50 years of age with diabetes mellitus and one additional risk factor for atherosclerosis; or
with a known atherosclerotic disease in another vascular bed such as coronary, carotid, subclavian, renal, or mesenteric artery stenosis, or abdominal aortic aneurysm.
Section 1861(ww)(2) of the Social Security Act (42 U.S.C. 1395x(ww)(2)) is amended—
in subparagraph (N), by moving the margins of such subparagraph 2 ems to the left;
by redesignating subparagraph (O) as subparagraph (P); and
by inserting after subparagraph (N) the following new subparagraph:
in paragraph (1)—
in subparagraph (N), by inserting and other than peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(nnn))
after other than personalized prevention plan services (as defined in section 1861(hhh)(1))
;
by striking and
before (HH)
; and
by adding at the end the following: and (II) with respect to peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(nnn)), the amount paid shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848;
; and
in paragraph (2)—
in subparagraph (G), by striking and
at the end;
in subparagraph (H), by striking the semicolon at the end and inserting ; and
; and
by inserting after subparagraph (H) the following new subparagraph:
Section 1833(b) of the Social Security Act (42 U.S.C. 1395l(b)) is amended, in the first sentence—
by striking , and
before (13)
; and
by inserting before the period at the end the following: , and (14) such deductible shall not apply with respect to peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(nnn))
.
Section 1833(t)(1)(B)(iv) of the Social Security Act (42 U.S.C. 1395l(t)(1)(B)(iv)) is amended—
by striking , or personalized
and inserting , personalized
; and
, or peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(nnn))after
personalized prevention plan services (as defined in section 1861(hhh)(1)).
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is amended by striking (2)(FF) (including administration of the health risk assessment),
and inserting (2)(FF) (including administration of the health risk assessment), (2)(KK),
.
Section 1862(a)(1) of the Social Security Act (42 U.S.C. 1395y(a)(1)) is amended—
in subparagraph (O), by striking and
at the end;
in subparagraph (P), by striking the semicolon at the end and inserting , and
; and
by adding at the end the following new subparagraph:
Section 1834(n) of the Social Security Act (42 U.S.C. 1395m(n)) is amended—
by redesignating subparagraphs (A) and (B) of paragraph (1) as clauses (i) and (ii), respectively, and moving the margins of such clauses, as so redesignated, 2 ems to the right;
by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and moving the margins of such subparagraphs, as so redesignated, 2 ems to the right;
Certain Preventive Servicesand all that follows through
any other provision of this titleand inserting:
Certain Preventive Services.—
by adding at the end the following new paragraph:
The amendments made by this section shall apply with respect to items and services furnished on or after January 1, 2026.
in subsection (a)—
in paragraph (31), by striking and
at the end;
by redesignating paragraph (32) as paragraph (33); and
by inserting after paragraph (31) the following new paragraph:
by adding at the end the following new subsection:
noninvasive physiologic studies of extremity arteries (commonly referred to as ankle-brachial index testing);
arterial duplex scans of lower extremity arteries vascular; and
such other items and services as the Secretary determines, in consultation with relevant stakeholders, to be appropriate for screening for peripheral artery disease for at-risk beneficiaries.
The term at-risk beneficiary means an individual enrolled under a State plan (or a waiver of such plan)—
who is 65 years of age or older;
who is at least 50 years of age but not older than 64 years of age with risk factors for atherosclerosis (such as diabetes mellitus, a history of smoking, hyperlipidemia, and hypertension) or a family history of peripheral artery disease;
who is younger than 50 years of age with diabetes mellitus and one additional risk factor for atherosclerosis; or
with a known atherosclerotic disease in another vascular bed such as coronary, carotid, subclavian, renal, or mesenteric artery stenosis, or abdominal aortic aneurysm.
The Secretary shall, in consultation with appropriate organizations, establish standards regarding the frequency for peripheral artery disease screening tests described in subsection (a)(31) for purposes of coverage under a State plan under this title.
in subparagraph (I), by striking or
at the end;
in subparagraph (J), by striking ; and
and inserting , or
; and
by adding at the end the following new subparagraph:
following paragraph (31)and inserting
following paragraph (32).
Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended by striking following paragraph (31)
and inserting following paragraph (32)
.
The Secretary of Health and Human Services (referred to in this section as the Secretary
) shall, in consultation with relevant stakeholders, develop quality measures for nontraumatic, lower-limb, major amputation that utilize appropriate diagnostic screening (including peripheral artery disease screening) in order to encourage alternative treatments (including revascularization) in lieu of such an amputation.
the merit-based incentive payment system under section 1848(q) of such Act (42 U.S.C. 1395w–4(q));
incentive payments for participation in eligible alternative payment models under section 1833(z) of such Act (42 U.S.C. 1395l(z));
the shared savings program under section 1899 of such Act (42 U.S.C. 1395jjj);
models under section 1115A of such Act (42 U.S.C. 1315a); and
such other payment systems or models as the Secretary may specify.