S. 4583 · Where this bill is now
In committee
Introduced in the Senate, May 20, 2026
What this bill does
In plain words · AI-written from the official summaryMedicare beneficiaries can contract with non-participating providers
This bill lets people on Medicare make private contracts with doctors and other health professionals—even ones who don't normally work with Medicare—for services Medicare would normally cover. When that happens, the Medicare beneficiary pays the provider directly and can submit a claim to get Medicare reimbursed. The bill says Medicare will pay as if the provider were participating in the program, and it prevents states from limiting what these providers can charge.
How it affects you
If you're on Medicare, this could give you more flexibility to see providers outside the regular Medicare network. You'd pay them upfront and then seek reimbursement from Medicare yourself, or negotiate with them to handle the claim for you. The main effect is on Medicare beneficiaries who want to work with non-participating providers for services Medicare covers.
Read the official summary (Introduced in Senate, May 20, 2026)
Legalizing Premium Health Care Act of 2026
This bill allows any Medicare beneficiary to enter into a contract with an eligible professional, regardless of whether the professional is participating in Medicare, for any item or service covered by Medicare.
Such beneficiaries may submit a claim for Medicare payment in the amount that would otherwise apply, except that, where the professional is considered to be non-participating, payment shall be made as if the professional were participating. An eligible professional is a physician, physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse-midwife, clinical social worker, clinical psychologist, registered dietitian or nutrition professional, physical or occupational therapist, qualified speech-language pathologist, or qualified audiologist.
A Medicare beneficiary must agree in writing in such a contract to (1) pay the eligible professional for a Medicare-covered item or service; and (2) submit, in lieu of the eligible professional, a claim for Medicare payment. However, a beneficiary may negotiate, as a term of the contract, for the eligible professional to file such claims on the beneficiary's behalf.
The bill preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.
Written by AI (Claude) using only the official summary by the Congressional Research Service, the Library of Congress’s nonpartisan research staff. It can miss nuance, so check the official summary and the bill text for details.
2nd SessionS. 4583
A BILL
Legalizing Premium Health Care Act of 2026
Sponsor: Sen. Rand Paul (R-KY) · Introduced May 20, 2026 · Health · 1 version of the text
Sources: Congress.gov actions and votes · bill text from GovInfo · latest official action May 20, 2026: “Read twice and referred to the Committee on Finance.”