Medicare Audiology Access Improvement Act of 2025

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1996 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 1996

To amend title XVIII of the Social Security Act to improve coverage of 
 audiology services under the Medicare program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 9, 2025

  Ms. Warren (for herself, Mr. Paul, Mr. Grassley, Mrs. Shaheen, Mr. 
    Welch, Mr. King, Ms. Klobuchar, and Mr. Booker) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to improve coverage of 
 audiology services under the Medicare program, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Audiology Access 
Improvement Act of 2025''.

SEC. 2. COVERAGE OF AUDIOLOGY SERVICES UNDER THE MEDICARE PROGRAM.

    (a) In General.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
            (1) in subparagraph (JJ), by inserting ``and'' after the 
        semicolon at the end; and
            (2) by adding at the end the following new subparagraph:
            ``(KK) audiology services (as defined in subsection 
        (ll)(3));''.
    (b) Improved Access to Audiology Services.--Paragraph (3) of 
section 1861(ll) of the Social Security Act (42 U.S.C. 1395x(ll)) is 
amended to read as follows:
    ``(3) The term `audiology services' means such hearing and balance 
assessment services and, beginning January 1, 2027, such treatment 
services, furnished by a qualified audiologist which the qualified 
audiologist is legally authorized to perform under State law (or the 
regulatory mechanism provided by State law), as would otherwise be 
covered if furnished by a physician or as incident to a physician's 
service. A qualified audiologist shall be permitted to furnish such 
audiology services without regard to any requirement that the 
individual receiving such audiology services is under the care of (or 
referred by) a physician or other health care practitioner or that such 
services are furnished under the supervision of a physician or other 
health care practitioner.''.
    (c) Payment Amount and Coinsurance.--Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)) is amended--
            (1) by striking ``and'' before (HH); and
            (2) by inserting the following before the semicolon: ``and 
        (II) with respect to audiology services furnished under section 
        1861(s)(2)(KK), the amounts paid shall be 80 percent of the 
        lesser of the actual charge for the services or the fee 
        schedule amount provided under section 1848''.
    (d) Payment on Assignment-Related Basis.--Section 1842(b)(18)(C) of 
the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by 
adding at the end the following new clause:
                            ``(ix) A qualified audiologist (as defined 
                        in section 1861(ll)(4)(B)).''.
    (e) Inclusion of Qualified Audiologists as RHC and FQHC 
Practitioners.--Section 1861(aa)(1)(B) of the Social Security Act (42 
U.S.C. 1395x(aa)(1)(B)) is amended--
            (1) by striking ``or by a mental'' and inserting ``by a 
        mental''; and
            (2) by inserting ``or by a qualified audiologist (as 
        defined in subsection (ll)(4)(B)),'' after ``(as defined in 
        subsection (lll)(4)),''.
    (f) Rule of Construction.--Nothing in the amendments made by this 
section shall be construed to expand the scope of audiology services or 
services for which payment may be made to other providers under title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) beyond those 
services for which such payment may be made as of December 31, 2026.
    (g) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2027.
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