This bill reforms how Medicare pays for skin substitute products—advanced biological treatments used for chronic, non-healing wounds like diabetic foot ulcers that affect millions of Medicare beneficiaries annually. Currently, Medicare's payment system incentivizes the use of more expensive products and hasn't kept pace with rising costs, despite evidence showing that different skin substitutes have similar clinical effectiveness. Beginning January 1, 2026, the bill establishes a unified payment rate based on a volume-weighted average of prices from late 2023, with future adjustments tied to inflation rather than individual product pricing. The legislation also requires Medicare to treat all skin substitutes equally under coverage rules and prevents manufacturers from having to report average sales prices for these products, though Medicare retains the authority to exclude products deemed unsafe due to contamination or serious adverse reactions. The goal is to stabilize costs while ensuring beneficiaries continue to have access to these clinically proven wound treatments.
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