The No UPCODE Act is a cut to Medicare Advantage

Senior woman with short hair looking into camera
The No UPCODE Act would make harmful cuts to Medicare, undermining benefits and weakening care coordination for millions of seniors. Vulnerable populations, including low income, rural, and chronically ill beneficiaries, would be hit the hardest. 

How no upcode harms seniors

Cuts to Benefits and Higher Costs 

  • The No UPCODE Act would cut Medicare Advantage by $62 billion over 10 years — leading to plan closures, higher costs, and reduced health benefits for seniors. 

Weaker Care Coordination 

  • The No UPCODE Act would threaten in-home health assessments in Medicare Advantage — depriving millions of seniors of convenient preventive care.

  • Without these assessments, seniors with diabetes, heart disease, or cognitive decline face greater risk of emergency room visits and hospitalizations. 

Disproportionate Impact on Vulnerable Populations 

  • Beneficiaries most likely to benefit from in-home visits and supplemental services, including low-income, rural, and chronically ill seniors, would face disproportionate harm under the No UPCODE Act. 

Why In-Home Health Assessments Matter

A nurse takes a blood pressure reading of a senior woman. They are in a house sitting on a couch.
In home-health assessments are clinical visits to a beneficiary’s home conducted by licensed physicians, nurse practitioners, or physician assistants. 

These assessments uncover fall risks, unmanaged chronic conditions, and unmet social needs that are often missed in traditional clinical settings. 

They connect seniors to the right care at the right time, improving outcomes and reducing costly hospitalizations.
The No UPCODE Act would exclude diagnoses from these assessments, putting seniors at risk of missed early interventions and threatening critical funding for their care. 

A Better Path Forward

Responsible reforms that strengthen program integrity while preserving seniors’ access to preventive, coordinated care.

Promote Enhanced Follow Up Care


Require Medicare Advantage plans to follow up after health risk assessments and coordinate with primary care physicians.

Strengthen Oversight and Transparency


Document follow-up activities, integrate health risk assessment data into care systems, and make performance metrics publicly available.

Standardize Health Risk Assessment Requirements


Align with CMS best practices and ensure ongoing evaluation for continuous improvement.

The No UPCODE Act is a cut to Medicare that will reduce benefits and weaken care for seniors. Instead of restricting in-home health assessments, policymakers should focus on strengthening oversight and protecting the preventive, coordinated care that seniors depend on.

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