Bill lets doctors charge Medicare patients extra fees above standard rates.
S. 4583 — Legalizing Premium Health Care Act of 2026 · Filed by Rand Paul (R-KY) · 1 cosponsor · Introduced May 20, 2026 · Referred to committee
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What it does
The bill lets Medicare patients and doctors make private deals. Patients pay doctors any price they agree on. Then Medicare pays its standard rate. Doctors can keep the extra money patients paid. The bill stops states from capping what doctors charge. Low-income seniors on both Medicare and Medicaid cannot use these deals.
Who it affects
Medicare patients who sign private deals may pay more out of pocket. Doctors can charge patients extra fees above what Medicare pays. Low-income seniors on both Medicare and Medicaid are blocked from these deals.
One thing to notice
Doctors can get paid twice for the same service. They get money from the patient and from Medicare.
From the analysis of the bill text, linked under Primary records below.
Where it stands
1 cosponsor: 1 Republicans.
- May 20, 2026 — Introduced · Congress.gov: “Introduced in Senate”
- May 20, 2026 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Words to know
- Medicare — Health insurance for people age 65 and older, run by the government.
- private deals — Contracts between patients and doctors outside normal Medicare payment rules.
- standard rate — The fixed amount Medicare normally pays doctors for a service.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (7,416 characters) on Jun 3, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,778 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
As of — page rendered 2026-11-01.
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