119 HR 9532 IH: No Medicare Clawbacks Act of 2026 U.S. House of Representatives 2026-06-29 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I119th CONGRESS2d SessionH. R. 9532IN THE HOUSE OF REPRESENTATIVESJune 29, 2026Mr. Torres of New York (for himself and Ms. Clarke of New York) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedA BILLTo amend title XVIII of the Social Security Act to prohibit group health plan payment clawbacks in certain circumstances.

1.

Short title

This Act may be cited as the No Medicare Clawbacks Act of 2026.

2.

Prohibiting group health plan payment clawbacks in certain circumstances

Section 1862(b) of the Social Security Act (42 U.S.C. 1395y(b)) is amended— (1)in paragraph (1)(A)(ii)— (A)by striking Clause (i) and inserting the following: (I)

In general

Clause (i); and (B)by adding at the end the following new subclause: (II)

Prohibition on payment clawbacks in certain circumstances

In the case of an item or service furnished to an individual entitled to benefits under this title under section 226(a) who is also enrolled in a group health plan, if clause (i) would otherwise apply to such individual and plan but for application of subclause (I) and if such plan initially makes payment for such item or service without regard to such entitlement, such plan may not later recoup such payment, in whole or part, on the basis that such individual was so entitled to such benefits, provided that— (aa)such item or service was furnished during a period of retroactive coverage of part A benefits applicable to such individual; and (bb)at the time such item or service was furnished, such individual was not behind on any employee contribution owed by such individual with respect to enrollment in such plan. ; and (2)in paragraph (3)(A), by inserting or in the case of a group health plan that recoups payment in violation of paragraph (1)(A)(ii)(II) before the period.