S. 4583 — Legalizing Premium Health Care Act of 2026

This section revises Medicare private contracting rules to permit any beneficiary to enter a written contract with an eligible professional (whether participating or non-participating) for covered items and services. The beneficiary may submit claims and receive payment at the participating rate, or negotiate for the professional to file claims and receive assignment; the professional is not treated as participating or non-participating for other purposes, section 1848(g) charge limits do not apply, and the beneficiary is held harmless for any amounts above the contract price. Contracts are barred for dual eligibles and during emergencies.

This section preempts state laws that limit charges by eligible professionals, as defined in section 1848(k)(3)(B) of the Social Security Act, for services paid under the Medicare physician fee schedule. It applies the preemption to the District of Columbia, Puerto Rico, the Virgin Islands, Guam, and American Samoa.