Payments by Medicare or an applicable plan count toward the cap
Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, section 6106, Sec. 6106.
Written by .
Payments by Medicare or an applicable plan count toward the cap
The document says “is amended”Who acts: CongressHow: statuteSec. 6106 in the PDF
What the document says
“``(III) payments made under title XVIII or by an applicable plan (as defined in section 1862(b)(8)(F)) for such services.''”
Section 6106 adds a new subclause (III) to section 1923(g)(1)(A)(ii) of the Social Security Act, adding payments made under title XVIII, the Medicare title, or by an applicable plan as defined in section 1862(b)(8)(F), to what is counted for the payment adjustment limit.
What the document actually says
“``(III) payments made under title XVIII or by an applicable plan (as defined in section 1862(b)(8)(F)) for such services.''”
That sentence, in plain words
Count what other payers paid for the same care. That means one big federal health plan and certain other plans.
What this is about
The cap is worked out from what a hospital spent and what it was paid. Adding a payer to that count lowers the gap the cap allows.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.
Consolidated Appropriations Act, 2026, Public Law 119-75, sec. 6106, 140 Stat. 643 (2026). https://www.govinfo.gov/content/pkg/PLAW-119publ75/html/PLAW-119publ75.htm
This page
“Payments by Medicare or an applicable plan count toward the cap,” Consolidated Appropriations Act, 2026, section 6106, Sec. 6106. Read the Mandate, https://readthemandate.org/consolidated-appropriations-act-2026/proposal/sec6106-other-payers-counted/ (retrieved October 10, 2026).
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