S. 438: Improved Medical Decision Incentive Act of 2009

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S. 438: Improved Medical Decision Incentive Act of 2009

111th Congress · introduced 2009-02-13 · Health · Latest: Read twice and referred to the Committee on Finance.

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Official title

Improved Medical Decision Incentive Act of 2009

Plain summary

Improved Medical Decision Incentive Act of 2009 - Allows a state health department to approve best practices in a course of, or as a means of treatment for, a particular condition, illness, or procedure, as the qualifying standard of care for the state in order to take advantage of the differential rates of payment implemented under the Social Security Act and the private insurance incentive under this Act. Requires a state health department, among other conditions for state approval, to allow any duly constituted state medical society or medical speciality group to file with the state health department a course or means of treatment representing best practices for a particular condition, illness, or procedure. Requires any interstate health insurer providing health care coverage within a state with approved qualifying best practices to pay all provider charges for any service provided in accordance with such practices. Authorizes any such provider or specialty group to bring a civil action in an appropriate U.S. district court to enjoin efforts by any health insurer to challenge or delay payment for services provided by the provider or a member of the specialty group in accordance with such best practices. Amends titles XVIII (Medicare) and XIX (Medicaid) to provide for implementation of differential rates of payment for covered items and services (except those in a clinical trial or study or, in exceptional circumstances, requiring non-standard care) that favor treatment consistent with qualifying best practices approved under the Medicare and Medicaid programs. Requires the Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, to review annually and report to Congress on the efficacy of all qualifying best practices approved pursuant to this Act and, if applicable, any national best practices adopted pursuant to this Act. Requires the Secretary also to host an annual conference on best practices for all state health directors, any state medical societies and medical specialty groups that have filed best practices for state approval, and any health insurers and advocacy groups that have participated in any administrative proceeding to approve best practices.

Congressional Research Service summary (Introduced in Senate), quoted unchanged (nonpartisan). Read the source.

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Alternatives

Needs sources: no published alternatives yet (for example a different bill, a law instead of an amendment, or keeping current law). We only show items backed by a published source. Suggest one.

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Officials and money

Sponsor: Sen. Whitehouse, Sheldon [D-RI] · 0 cosponsors

Cost estimate: No cost estimate published yet.

Sponsor's campaign money: Sen. Whitehouse, Sheldon [D-RI] reported raising $652,856 (2025–2026). Details. Shown for context only; it does not mean any donor supported this bill.

No linked floor roll calls in our collected records yet. This does not mean the bill has never had a vote. Check the official bill history.

Sources

• Congressional Research Service summary (Introduced in Senate)
• Congress.gov
• Data: GovInfo BILLSTATUS bulk data (Library of Congress), BILLSTATUS-111s438.xml <https://www.govinfo.gov/bulkdata/BILLSTATUS/111/s>

Record fed-us-cong111-s438 · catalog fed-us-congress-bills-cong111 · updated 2026-11-15 by psicol fed-bills-cong111