H.R.3092 - Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2025 (119th Congress)
Summary
H.R.3092, the Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2025, aims to amend Title XVIII of the Social Security Act to introduce additional requirements for electrodiagnostic services under the Medicare program. The bill mandates that Medicare payments for specific electrodiagnostic services (nerve conduction studies and needle electromyography tests) will only be made if the services are furnished at a "qualified facility." These facilities must be accredited by organizations specified by the Secretary of Health and Human Services.
The Secretary is tasked with specifying accrediting organizations and establishing an advisory committee to provide recommendations on requirements and regulations. The bill outlines specific requirements for qualified facilities, including quality assurance programs, appropriate equipment, and qualified personnel.
Ultimately, the goal is to enhance the reliability, safety, and accuracy of electrodiagnostic services while reducing fraud and abuse within the Medicare program.
Expected Effects
The bill will likely lead to increased standardization and oversight of electrodiagnostic services provided under Medicare. Smaller facilities without accreditation may face challenges in providing these services, potentially leading to consolidation within the industry. Patients may experience improved quality of care due to the mandated standards, but access could be affected if fewer facilities offer these services.
Potential Benefits
- Improved Quality of Care: Accreditation requirements ensure facilities maintain quality assurance and control programs.
- Reduced Fraud and Abuse: By requiring accreditation, the bill aims to eliminate fraudulent or unnecessary electrodiagnostic services.
- Enhanced Reliability of Diagnoses: Standardized procedures and qualified personnel contribute to more accurate test results.
- Better-Trained Personnel: Mandates for training in performing and interpreting electrodiagnostic studies ensure qualified professionals are conducting the tests.
- Reduced Unnecessary Treatments: The advisory committee's focus on reducing unnecessary treatments and surgeries could lead to more appropriate care pathways.
Potential Disadvantages
- Reduced Access to Care: Smaller, rural facilities may struggle to meet accreditation requirements, potentially limiting access to services in underserved areas.
- Increased Costs: The cost of accreditation and compliance may be passed on to patients or the Medicare program.
- Potential for Consolidation: Smaller practices may be forced to merge with larger entities to afford accreditation, reducing competition.
- Administrative Burden: The Secretary of HHS faces a significant administrative burden in specifying accrediting organizations and establishing the advisory committee.
- Delayed Implementation: The timeline for implementation (3-4 years after enactment) could delay the benefits of the legislation.
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution, as it aims to improve the quality and reduce fraud in Medicare, a government program designed to promote the health and well-being of the elderly and disabled. The establishment of an advisory committee and the delegation of accreditation authority to the Secretary of HHS are consistent with Congress's power to enact laws necessary and proper for carrying out its enumerated powers (Article I, Section 8). There are no apparent infringements on individual rights or liberties guaranteed by the Constitution.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).