WASHINGTON – U.S. Senator Bill Cassidy, M.D. (R-LA) introduced the Skin Substitute Access and Payment Reform Act of 2025 to update and reform Medicare’s payment system for skin substitute products—advanced biological therapies used to treat chronic, non-healing wounds such as diabetic foot ulcers and venous leg ulcers.
“Tens of millions of Americans depend on these treatments—there is no excuse for letting price gouging exploit their need for such care. Under the current Medicare payment system, treatment for non-healing wounds can cost more than an ambulance ride. My bill modernizes reimbursement rules, lowers costs, and ensures patients get the care they need without reducing access,” said Dr. Cassidy.
The Skin Substitute Access and Payment Reform Act of 2025 would:
- Establish a new consolidated billing and payment code for all skin substitute products beginning January 1, 2026
- Set payment limits based on a volume-weighted average of current product prices to ensure fair and consistent reimbursement
- Recognize the similar clinical effectiveness of various skin substitute products, allowing healthcare providers to select the best treatment for each patient without financial penalty
- Prevent Medicare from using flawed clinical evidence to deny coverage of skin substitute products unless safety concerns arise
- Exclude skin substitutes from average sales price reporting requirements to reduce administrative burdens
Background
Each year, more than 10.5 million Medicare beneficiaries require care for chronic wounds, which pose serious health risks and can lead to complications including amputation. Skin substitute products improve healing and patient outcomes, but the current Medicare payment system has struggled with inconsistent pricing and incentives that favor more expensive products, driving up costs for seniors and taxpayers.
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