119th Congress · introduced in the Senate · Mar 25, 2025
No UPCODE Act
Official title from Congress.gov
Latest action (Mar 25, 2025): Read twice and referred to the Committee on Finance.
View on Congress.govPolicy area: Health
Congressional Research Service summary, version: Introduced in Senate (Mar 25, 2025)
No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act
This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data.
Specifically, the bill requires the Centers for Medicare & Medicaid Services (CMS) to use two years of diagnostic data in its risk adjustment methodology for MA payments. It also prohibits the CMS from using diagnoses that are collected from chart reviews or health risk assessments when adjusting payments based on health status. The CMS must also take into account any differences in coding patterns between MA and traditional Medicare when determining MA payment adjustments.
Includes amendment, cloture, and procedural votes. Each is labeled with its exact question; only a passage question is a vote to pass the bill.
No recorded roll calls on this bill in coverage.
Read twice and referred to the Committee on Finance.
Introduced in Senate
Actions from Congress.gov, newest first.
LD-2 reports whose issue descriptions explicitly cite this bill (bill type and number validated against Congress.gov records). A citation does not establish the client's position or any contact with a member.
Loading lobbying reportsCoverage: reports for 2025 onward, posted Jan 1, 2025 through Oct 24, 2026.
238 citations; showing the 25 most recently posted.
BCBSM INC · lobbying firm or registrant: BCBSM, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 21, 2026 · issue area: Budget/Appropriations
$30,000
Spent on own lobbying
…ncreases the statutory debt limit, and otherwise addresses agencies and programs throughout the federal government. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA]
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
CVS HEALTH (AND SUBSIDIARIES) · lobbying firm or registrant: CVS HEALTH (AND SUBSIDIARIES)
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 21, 2026 · issue area: Medicare/Medicaid
$2,040,000
Spent on own lobbying
…Medicare Shared Savings Program. Issues related to Medicaid. S. 882, The Patients Before Middlemen (PBM) Act S. 927, The Protecting Pharmacies in Medicaid Act S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act S. 3345, The PBM Price Transparency and Accountability Act H.R. 4317, The Pharmacy Benefit…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICA'S HEALTH INSURANCE PLANS INC (AHIP) · lobbying firm or registrant: AMERICA'S HEALTH INSURANCE PLANS, INC. (AHIP)
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$3,010,000
Spent on own lobbying
…n Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based serv…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
HIGHMARK INC · lobbying firm or registrant: HIGHMARK, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$300,000
Spent on own lobbying
…ncy H.R.8375 - Medicare Advantage Improvement Act of 2026 - A bill to provide for certain reforms under the Medicare Advantage program, and for other purposes. S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act (No UPCODE) Act - This bill modifies certain factors that are used to determine Medicare A…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
UNITEDHEALTH GROUP INC · lobbying firm or registrant: AVENUE SOLUTIONS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$120,000
Paid to lobbying firm
Issues relating to Medicare Advantage; Issues related to the use of AI and its correlation to prior authorization and utilization management policies; S. 1105, No UPCODE Act; Issues related to Senate Finance Dear Colleague process
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
SNP ALLIANCE INC · lobbying firm or registrant: AVENUE SOLUTIONS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
…rk setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star Ratings
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
SCAN HEALTH PLAN · lobbying firm or registrant: AVENUE SOLUTIONS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
…arks, health risk assessments, prompt pay, and brokers; Issues related to Medicare Advantage marketing practices, provider directories and prior authorization; S. 1105, No UPCODE Act; Issues related to street medicine; MedPAC nomination process; Issues related to Senate Finance Dear Colleague process
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
BLUE CROSS BLUE SHIELD ASSOCIATION · lobbying firm or registrant: AVENUE SOLUTIONS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$80,000
Paid to lobbying firm
Issues related to Medicare Advantage; Issues related to site neutral payments; Issues related to PBM reforms; S. 1105, No UPCODE Act
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
BETTER MEDICARE ALLIANCE, INC. · lobbying firm or registrant: BETTER MEDICARE ALLIANCE, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$290,000
Spent on own lobbying
…FY2030, modifies, and establishes programs under the Older Americans Act, which supports social services and activities for individuals aged 60 years or older. S.1105--No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act--An act to improve the way Medicare Advantage plans assess patients health risk…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
ELEVANCE HEALTH, INC. · lobbying firm or registrant: ELEVANCE HEALTH, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$1,410,000
Spent on own lobbying
…ental Benefits In-Home Health Risk Assessments and Chart Review Medicare Stars Program The Apples-to-Apples Comparison Act (H.R. 4093 & S. 3848) No UPCODE Act (S. 1105) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare S…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN ACADEMY OF OPHTHALMOLOGY · lobbying firm or registrant: AMERICAN ACADEMY OF OPHTHALMOLOGY
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Health Issues
$254,772
Spent on own lobbying
…e Medicare Patient Access and Practice Stabilization Act of 2025 Healthcare Workforce Issues S. 864, the Help Ensure Lower Patient Copays Act (HELP Copays Act) S. 1105, the No Upcode Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 2527, the Early Detection of Vision Impairments for Children Act of 2024 (ED…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
NATIONAL ASSOCIATION OF ACCOUNTABLE CARE ORGANIZATIONS · lobbying firm or registrant: NATIONAL ASSOCIATION OF ACCOUNTABLE CARE ORGANIZATIONS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$177,310
Spent on own lobbying
…iciency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 8129: To amend title XV…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
UNIVERSITY OF PITTSBURGH MEDICAL CENTER HEALTH PLAN · lobbying firm or registrant: BUCHANAN INGERSOLL & ROONEY PC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Insurance
$50,000
Paid to lobbying firm
PBM Reform; Medicare Advantage payment issues; Medicaid Reform; One Big Beautiful Bill Act (H.R. 1, P.L. 119-21); enhanced premium tax credits; S.1105, No UPCODE Act; HR 5454, Medicare Advantage Prompt Pay Act
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
UNIVERSITY OF PITTSBURGH MEDICAL CENTER HEALTH PLAN · lobbying firm or registrant: BUCHANAN INGERSOLL & ROONEY PC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
PBM Reform; Medicare Advantage payment issues; Medicaid Reform; One Big Beautiful Bill Act (H.R. 1, P.L. 119-21); S.1105, No UPCODE Act; HR 5454, Medicare Advantage Prompt Pay Act
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
UNIVERSITY OF PITTSBURGH MEDICAL CENTER HEALTH PLAN · lobbying firm or registrant: BUCHANAN INGERSOLL & ROONEY PC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Health Issues
$50,000
Paid to lobbying firm
PBM Reform; Medicare Advantage payment issues; Medicaid Reform; One Big Beautiful Bill Act (H.R. 1, P.L. 119-21); enhanced premium tax credits; S.1105, No UPCODE Act
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
MONOGRAM HEALTH · lobbying firm or registrant: MEHLMAN CONSULTING, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
Issues related to the value of in-home care for rural and underserved patients. Medicare Advantage reimbursement, as well as coding and billing issues. S. 1105, the No Upcode Act
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
ELEVANCE HEALTH, INC. · lobbying firm or registrant: MEHLMAN CONSULTING, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$90,000
Paid to lobbying firm
…age, Medicare Part D, Medicaid Managed Care. Issues related to prescription drug costs and delivery. PBM Reform issues. CY 2027 Medicare Advantage Rate Notice. S. 1105 - No UPCODE Act. H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
BLUE SHIELD OF CALIFORNIA · lobbying firm or registrant: MEHLMAN CONSULTING, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Health Issues
$50,000
Paid to lobbying firm
Issues related to prescription drug pricing and transparency. Issues related to health IT & interoperability. S.1105 - No UPCODE Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
BLUE CROSS BLUE SHIELD MICHIGAN · lobbying firm or registrant: MEHLMAN CONSULTING, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$40,000
Paid to lobbying firm
Issues related to Medicare Advantage. Issues related to Medicaid managed care. S. 1105 - No UPCODE Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICA'S HEALTH INSURANCE PLANS · lobbying firm or registrant: MEHLMAN CONSULTING, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$90,000
Paid to lobbying firm
Issues related to Medicare and Medicaid payments and the Medicare Advantage Prescription Drug Pricing program. S.1105 - No UPCODE Act CY 2027 Medicare Advantage Rate Notice. H.R. 4093 - Apples to Apples Comparison Act of 2025. H.R. 5243 - To amend title XVIII of the Social Sec…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
HUMANA INC · lobbying firm or registrant: HUMANA, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 19, 2026 · issue area: Medicare/Medicaid
$1,520,000
Spent on own lobbying
…apitation Rates and Part C and Part D Payment Policies Final Calendar Year (CY) 2025 Part D Redesign Program Instructions PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare bene…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
BLUECROSS BLUESHIELD OF TENNESSEE · lobbying firm or registrant: BLUECROSS BLUESHIELD OF TENNESSEE
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 19, 2026 · issue area: Medicare/Medicaid
$420,000
Spent on own lobbying
Medicare Advantage (MA) and MA Rate Notice; Medicaid Cuts; Site Neutral Payment reform; MA Reform; Program Fraud Waste and Abuse; Durable Medical Equipment S. 1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage H.R. 842 - Nancy Gardner Sewell Medicare Mu…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN MEDICAL ASSOCIATION · lobbying firm or registrant: AMERICAN MEDICAL ASSOCIATION
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 19, 2026 · issue area: Medicare/Medicaid
$4,540,000
Spent on own lobbying
…ency Act, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected M…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
CENTER FOR HEALTH AND DEMOCRACY · lobbying firm or registrant: PORT SIDE STRATEGIES, LLC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 19, 2026 · issue area: Medicare/Medicaid
$20,000
Paid to lobbying firm
…support. H.R.3069 - Medicare for All Act - in support. Issues related to the Centers for Medicare and Medicaid Services. Issues related to Medicare Advantage. S.1105 - No UPCODE Act - in support. Issues related to the Wasteful and Inappropriate Service Reduction Model. S.J.Res.198 - A joint resolution providing for congress…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
JOINT COUNCIL OF ALLERGY ASTHMA & IMMUNOLOGY D/B/A ADVOCACY COUNCIL OF ACAAI · lobbying firm or registrant: CAPITOL ASSOCIATES, INC.
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 16, 2026 · issue area: Medicare/Medicaid
$40,000
Paid to lobbying firm
…Authorization Reform H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 Medicare Advantage burden reduction reform One Big Beautiful Bill Act S. 1105 - No Upcode Act Medicare coverage for allergy immunotherapy Protecting Approved Care Act Patients First Act
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing