S 1105

This bill, the No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act, aims to improve how Medicare Advantage payments are calculated. It requires the Centers for Medicare & Medicaid Services (CMS) to use two years of diagnostic data when determining payments, rather than relying solely on one year. The bill also prohibits CMS from using diagnoses collected through chart reviews or health risk assessments when adjusting payments based on a beneficiary’s health status. Finally, it requires CMS to analyze and report on differences in coding practices between Medicare Advantage and traditional Medicare plans.