HR307-119

What This Bill Does

The ARC Act addresses avoidable amputations from peripheral artery disease. Its findings say an estimated 21 million Americans have PAD and about 200,000 people, disproportionately minorities, experience avoidable amputations each year; African Americans living with diabetes may face up to four times the national average amputation risk, Native Americans more than twice the risk, and Hispanics up to 75 percent higher risk. The bill creates a CDC-led PAD education program in collaboration with CMS, HRSA, clinical organizations, patient advocates, and stakeholders to inform clinicians and the public, especially at-risk populations, about PAD and amputation reduction, with 6 million dollars authorized annually for fiscal years 2026 through 2030. It adds Medicare coverage for PAD screening tests for at-risk beneficiaries without deductible or cost sharing beginning January 1, 2026, including ankle-brachial index testing, lower-extremity arterial duplex scans, and other HHS-approved screening. At-risk Medicare and Medicaid beneficiaries include older adults, people ages 50 to 64 with atherosclerosis risk factors or family history, younger people with diabetes and another risk factor, and people with known atherosclerotic disease in another vascular bed. Medicaid must cover PAD screening without cost sharing for at-risk beneficiaries. HHS must develop and validate quality measures for nontraumatic lower-limb major amputation that encourage diagnostic screening and alternatives like revascularization, then incorporate them into Medicare quality reporting and payment systems. CMMI must test a voluntary amputation-prevention model for hospitals, ambulatory surgical centers, and office-based centers within 18 months, covering risk modification, early screening, surveillance, PAD testing, treatment, and care coordination.

Who Benefits and How

At-risk Medicare beneficiaries benefit from covered PAD screening without cost sharing beginning January 1, 2026. At-risk Medicaid beneficiaries benefit from the same no-cost-sharing PAD screening coverage through state plans or waivers. Patients at high risk for amputation benefit from education, early detection, revascularization alternatives, and CMMI prevention models. Minority patients with disproportionate PAD amputation risk benefit from outreach targeted to at-risk populations. Hospitals participating in prevention models benefit from a CMMI pathway to reduce amputations and costs. Clinical and patient advocacy organizations benefit from formal roles in education and stakeholder consultation.

Who Bears the Burden and How

CDC must establish and coordinate the PAD education program and disseminate best practices. CMS must implement Medicare PAD screening coverage, payment, frequency standards, and quality-reporting integration. State Medicaid agencies must cover qualifying PAD screening tests without cost sharing. HHS must test and validate amputation quality measures within 18 months. CMMI must test a voluntary nontraumatic lower-limb major amputation prevention model within 18 months. Providers and suppliers may need to report quality measures tied to diagnostic screening and amputation alternatives.

Key Provisions

• Creates a CDC-led peripheral artery disease education program with 6 million dollars annually authorized for fiscal years 2026 through 2030.
• Provides Medicare coverage of PAD screening tests for at-risk beneficiaries without cost sharing starting January 1, 2026.
• Provides Medicaid coverage of PAD screening tests for at-risk beneficiaries without cost sharing.
• Requires HHS quality measures for nontraumatic lower-limb major amputation and alternative treatments like revascularization.
• Requires CMMI to test an amputation-prevention model for hospitals, surgical centers, and office-based centers within 18 months.