To amend title XVIII of the Social Security Act to clarify the application of the in-office ancillary services exception to the physician self-referral prohibition for drugs furnished under the Medicare program.
Sponsors
Legislative Progress
IntroducedMs. Sinema (for herself and Mrs. Blackburn) introduced the following …
Summary
What This Bill Does
The Seniors' Access to Critical Medications Act of 2023 clarifies that physicians can administer drugs and necessary supplies to Medicare patients in their offices without violating federal "self-referral" rules (the Stark Law). It addresses confusion created by CMS guidance that had restricted this practice, and requires the removal of that restrictive guidance.
Who Benefits and How
Physicians benefit because they can continue providing in-office drug treatments to Medicare patients without fear of violating self-referral prohibitions. This preserves their ability to offer convenient, supervised medication administration in their practices.
Medicare Beneficiaries (Seniors) benefit because they can receive medications in their doctor's office rather than being referred elsewhere. This means more convenient access to treatments, potentially faster care, and supervision by their familiar physician.
Who Bears the Burden and How
Centers for Medicare & Medicaid Services (CMS) must remove FAQ guidance it published in 2021 and 2023, and treat that guidance as if it was never issued. This is an administrative burden requiring the agency to reverse its prior interpretation.
Key Provisions
- Amends Section 1877(b)(2) of the Social Security Act to clarify that the "in-office ancillary services exception" applies to drugs and supplies administered in physician offices
- Makes this clarification retroactive to May 11, 2023
- Requires CMS to remove FAQ guidance from September 2021 and May 2023 that restricted in-office drug administration
- Deems the removed FAQ guidance to have "never been published," effectively nullifying any enforcement actions based on it
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
This bill amends title XVIII of the Social Security Act to clarify the application of the in-office ancillary services exception to the physician self-referral prohibition for drugs furnished under the Medicare program.
Policy Domains
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
A rule that prevents physicians from referring patients to entities in which they have a financial interest, except under specific conditions.
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology