[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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