S.1702 - Access to Prescription Digital Therapeutics Act of 2025 (119th Congress)
Summary
S.1702, the "Access to Prescription Digital Therapeutics Act of 2025," aims to amend Titles XVIII and XIX of the Social Security Act to include coverage for prescription digital therapeutics (PDTs) under Medicare and Medicaid. The bill defines PDTs as software-driven products approved by the FDA for the prevention, management, or treatment of medical conditions. It mandates the establishment of payment methodologies and coding systems for these therapeutics, along with manufacturer reporting requirements.
Expected Effects
The bill would expand access to innovative digital health technologies for Medicare and Medicaid beneficiaries. This could lead to improved health outcomes and potentially lower healthcare costs in the long run. However, it also introduces new administrative and regulatory burdens for manufacturers and the government.
Potential Benefits
- Increased access to innovative healthcare technologies for Medicare and Medicaid beneficiaries.
- Potential for improved patient outcomes through the use of digital therapeutics.
- Creation of a framework for the coverage and payment of PDTs, fostering innovation in the digital health sector.
- Mandatory reporting requirements for manufacturers, promoting transparency in pricing and usage.
- May lead to cost savings in the long term by preventing or managing chronic conditions more effectively.
Potential Disadvantages
- Increased administrative burden for the Secretary of Health and Human Services to establish payment methodologies and coding systems.
- Potential for increased healthcare costs if PDTs are not effectively managed or priced.
- Risk of civil monetary penalties for manufacturers who fail to report accurate information.
- The definition of 'prescription digital therapeutic' may be too narrow or too broad, potentially excluding or including unintended products.
- The payment methodology may not accurately reflect the value and effectiveness of PDTs.
Constitutional Alignment
The bill aligns with the Constitution's general welfare clause (Preamble). Congress has the power to tax and spend for the general welfare, which includes providing healthcare benefits through Medicare and Medicaid. The bill does not appear to infringe on any specific constitutional rights or limitations.
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).