Ensuring Access to Essential Providers Act of 2025

This bill would require Medicare Advantage plans to meet an "essential community provider" standard. Plans would have to include a number of these providers, set by the Secretary of Health and Human Services, in their networks and offer to contract with each one in their service area. Essential community providers include community health centers, rural and safety-net hospitals, tribal health facilities, Ryan White HIV/AIDS clinics, and mental health or substance use treatment facilities. A plan that does not meet the standard would have to explain why and describe how it will meet the standard by the next plan year, and the Secretary would not approve plans with insufficient explanations. Plans would also have to pay federally qualified health centers at a rate set in existing law.

Full text and official record on Congress.gov

Sponsors

• Bill Cassidy Republican sponsor
• 1 cosponsors