CAT Act of 2025

Sponsor: Josh Harder (Democratic-CA)December 18, 2025

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Medicare would give doctors and hospitals more warning and appeal rights before stopping payments for fraud investigations.

This bill would make Medicare's process for stopping payments to doctors and hospitals more transparent. Currently, payments can be suspended for up to a year without much explanation. The bill would require Medicare to provide specific reasons for suspensions, give regular updates, and create a way for providers to appeal these decisions, helping good-faith providers stay open.

What Would Change

Currently, Medicare can stop payments to healthcare providers for up to a year based on fraud allegations, often without giving clear reasons or a way to appeal. This bill would generally limit these suspensions to 180 days, require Medicare to provide detailed reasons 30 days before stopping payments, give regular updates during investigations, and create an independent appeals process for providers.

Key Provisions

Requires Medicare to create an independent appeals process for healthcare providers whose payments are stopped due to fraud investigations.
Requires Medicare to tell healthcare providers specific details about fraud allegations at least 30 days before stopping payments.
Requires Medicare to give healthcare providers regular updates (every 30 days) during a payment suspension and a chance to ask questions.
Caps Medicare payment suspensions at 180 days unless there's a good reason to extend them.
Requires Medicare to immediately restart payments and pay back any missed amounts with interest if transparency rules are not followed.
Clarifies that simple billing errors or "mere error" would not be considered a "credible allegation of fraud" for payment suspensions.

View on Congress.gov

HR 6863 · 119th Congress · December 18, 2025 · AI Summary by gemini-2.5-flash · 9/10

CAT Act of 2025

What Would Change

Key Provisions

Lobbying Activity