What does Preamble of ARC Act of 2025 do?

This bill, formally titled '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,' aims to amend the Social Security Act. The proposed legislation seeks to provide coverage for peripheral artery disease screening tests. The bill intends to extend this coverage to beneficiaries considered 'at-risk' under Medicare and Medicaid programs. A key provision of the bill is the elimination of cost-sharing requirements for these screening tests.

What does SHORT TITLE; FINDINGS. of ARC Act of 2025 do?

This Act is formally titled the “Amputation Reduction and Compassion Act of 2025” or the “ARC Act of 2025”. The Act identifies atherosclerosis, particularly peripheral artery disease (PAD), as a significant health concern in the United States. PAD is linked to increased risks of heart attack, stroke, amputation, and death, affecting an estimated 21 million Americans. Minority groups, including African Americans, Native Americans, and Hispanics, experience disproportionately higher rates of amputation related to PAD. The Act highlights the high mortality rate following amputation, with significant percentages of patients dying within two years. Screening and arterial testing for PAD are considered cost-effective and should be integrated into routine medical care. Early detection and adherence to evidence-based care guidelines can reduce amputations and deaths associated with PAD. PAD diagnosis is associated with a 67-percent increase in the risk of cardiac death, emphasizing the importance of screening for cardiac risk factors.

What does PERIPHERAL ARTERY DISEASE EDUCATION PROGRAM. of ARC Act of 2025 do?

This section amends the Public Health Service Act to establish a Peripheral Artery Disease (PAD) Education Program. The Secretary, through the CDC Director, will collaborate with various agencies and organizations to coordinate the program. The program aims to support, develop, and implement educational initiatives and outreach strategies. These initiatives will focus on informing healthcare professionals and the public about PAD and methods to reduce amputations. The Secretary will identify and disseminate best practices related to PAD to healthcare professionals. The section authorizes $6,000,000 annually from fiscal years 2026 through 2030 to carry out the program.

What does MEDICARE COVERAGE OF PERIPHERAL ARTERY DISEASE SCREENING TESTS of ARC Act of 2025 do?

This section amends the Social Security Act to require Medicare coverage of peripheral artery disease (PAD) screening tests for at-risk beneficiaries without cost-sharing. PAD screening tests are defined as noninvasive physiologic studies of extremity arteries (ankle-brachial index testing) and arterial duplex scans, among other tests determined appropriate by the Secretary. At-risk beneficiaries include individuals 65 or older, those aged 50-64 with risk factors for atherosclerosis, those under 50 with diabetes and one additional risk factor, or those with known atherosclerotic disease in another vascular bed. The Secretary will establish standards for the frequency of these screening tests. The legislation modifies payment for these tests, generally setting the payment at 100% of the lesser of the actual charge or the amount determined under existing payment bases. A deductible will not apply to these screening tests. The authority to modify or eliminate coverage of certain preventive services does not apply to PAD screening tests. These changes will apply to services furnished on or after January 1, 2026.

What does MEDICAID COVERAGE OF PERIPHERAL ARTERY DISEASE SCREENING TESTS of ARC Act of 2025 do?

This section amends the Social Security Act to include peripheral artery disease (PAD) screening tests in Medicaid coverage. It defines 'peripheral artery disease screening test' to include ankle-brachial index testing and arterial duplex scans, with the Secretary having authority to determine other appropriate tests. The definition of 'at-risk beneficiary' includes individuals 65 or older, those 50-64 with atherosclerosis risk factors, those under 50 with diabetes and an additional risk factor, and those with known atherosclerotic disease in another vascular bed. The Secretary is tasked with establishing standards for the frequency of these screening tests. This section prohibits cost-sharing requirements for PAD screening tests furnished to at-risk beneficiaries under Medicaid. Conforming amendments are made to sections 1902(nn)(3) and 1905(a) of the Social Security Act.

What does DEVELOPMENT AND IMPLEMENTATION OF QUALITY MEASURES. of ARC Act of 2025 do?

This section requires the Secretary of Health and Human Services to develop quality measures for nontraumatic, lower-limb, major amputations. The development of these measures must involve consultation with relevant stakeholders and utilize diagnostic screening, including peripheral artery disease screening. The purpose of these measures is to encourage alternative treatments, such as revascularization, instead of amputation. Within 18 months of the Act's enactment, the Secretary must test and validate the developed measures. The Secretary must incorporate these measures into quality reporting programs for Medicare providers. These programs include the merit-based incentive payment system, incentive payments for alternative payment models, the shared savings program, and models under section 1115A. The Secretary can also specify other payment systems or models for incorporating these measures.

What does AMPUTATION PREVENTION PILOT PROGRAM. of ARC Act of 2025 do?

This section amends Section 1115A(b)(2)(B) of the Social Security Act. The amendment adds a clause promoting voluntary, nontraumatic lower-limb major amputation prevention programs. These programs aim to increase access to amputation prevention services, reduce amputation rates, and reduce costs. The programs will focus on patient risk modification, early screening, testing and treatment for peripheral artery disease, and improved care coordination. The Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation must test the described model within 18 months of the Act's enactment.

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ARC Act of 2025

Last updated: 1/14/2025 · Introduced: 1/9/2025

Author: LaMonica McIver (D-NJ)

TL;DR (AI)

The ARC Act of 2025 mandates Medicare and Medicaid coverage of peripheral artery disease (PAD) screening tests for at-risk individuals without cost-sharing.
The bill establishes a Peripheral Artery Disease (PAD) Education Program, allocating $6 million annually from 2026-2030 to educate healthcare professionals and the public about PAD prevention.
It requires the Secretary of Health and Human Services to develop quality measures for lower-limb amputations, encouraging alternative treatments like revascularization.
The legislation promotes voluntary amputation prevention pilot programs focused on early screening, treatment, and care coordination for PAD.
The bill expands the definition of 'at-risk beneficiary' to include individuals 65 or older, those with risk factors for atherosclerosis, and those with diabetes or known atherosclerotic disease.

119th Congressin committeeOfficial page

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Includes provisions on preamble, short title; findings., and 5 more.

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