Access to Prescription Digital Therapeutics Act of 2025
Access to Prescription Digital Therapeutics Act of 2025
Plain Language Summary
# Access to Prescription Digital Therapeutics Act of 2025 - Summary ## What the Bill Would Do This bill would require Medicare and Medicaid to cover prescription digital therapeutics—essentially medical software apps designed to prevent, manage, or treat health conditions. Currently, these digital treatments have limited coverage under these government health programs. If passed, the bill would establish rules for how much the government pays manufacturers for these digital therapeutics and require the Centers for Medicare & Medicaid Services (CMS) to create a payment system that considers factors like how often patients use the apps. ## Who It Affects and Key Provisions The bill primarily affects seniors and low-income individuals on Medicare and Medicaid, as well as software companies that develop medical apps.
It requires manufacturers to report information about which private insurance companies cover their products, with penalties for failing to comply. The goal is to make prescription digital therapeutics more accessible and affordable for patients who might benefit from them, while ensuring transparency about how these products are being used and paid for across different insurance types. ## Current Status The bill is currently in committee (as of the information provided), meaning it has been introduced but hasn't yet been voted on by the full House of Representatives. It was sponsored by Representative Kevin Hern (R-OK).
CRS Official Summary
Access to Prescription Digital Therapeutics Act of 2025This bill provides for Medicare and Medicaid coverage of prescription digital therapeutics (i.e., software applications that are used to prevent, manage, or treat medical conditions). The Centers for Medicare & Medicaid Services must establish a Medicare payment methodology for payments to manufacturers that takes into account certain factors (e.g., ongoing use); manufacturers must report specified information about private payors, subject to civil penalties.
Latest Action
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.