The Stand Strong for Medicare Act of 2025 would expand Medicare coverage to include specific fall prevention items like grab bars, non-slip mats, shower chairs, and bed rails. It removes the requirement that these items must be provided under a physician's order, making them easier for beneficiaries to access. The bill also ensures payments for these items are exempt from automatic budget cuts under current law. This change directly benefits Medicare beneficiaries, particularly older adults at risk of falls, by improving access to essential safety equipment.
This bill requires hospitals with approved medical residency programs to publicly report data on applicants and acceptances from both osteopathic (D.O.) and allopathic (M.D.) medical schools. Specifically, hospitals must submit annual data showing the number of applicants and accepted candidates from each school type, along with a written affirmation that they consider both equally and accept scores from either the COMLEX or USMLE exams. The data must be published online by the Health and Human Services Secretary starting in 2025. Hospitals failing to submit this information face a 2% annual reduction in Medicare payments beginning in 2026. The bill explicitly states it does not mandate specific acceptance rates or federalize medical education.
This bill prohibits Medicare-approved medical residency programs from requiring residents to undergo abortion-related training without their voluntary opt-in. It specifically bans programs from mandating such training or discriminating against residents who choose not to participate in abortion care (including counseling or referrals). The law applies directly to medical residents in Medicare-funded postgraduate training programs. Key provisions ensure residents can opt out without penalty and prevent programs from penalizing those who decline abortion-related instruction.
This bill requires healthcare facilities to create written policies about patient visitation rights under the Social Security Act. It mandates that facilities inform patients of their right to choose visitors (including spouses, family, or friends) and withdraw consent anytime, while prohibiting restrictions based on race, disability, or other protected characteristics. Facilities must also clearly explain any clinical restrictions on visitation and ensure equal privileges for all visitors. The law directly affects patients in healthcare institutions and the facilities providing their care.
The Independent BROKERS TIME Act of 2025 requires the Health and Human Services Secretary to update Medicare regulations defining third-party marketing organizations (TPMOs), clarifying distinctions between TPMOs and independent agents/brokers - particularly addressing call centers outside the U.S. and lead-generation revenue models. It mandates rulemaking to create a reward for reporting Medicare marketing scams, establish a standardized registration process for independent agents to reduce regulatory burdens, and eliminate a 48-hour waiting period before agents meet with Medicare beneficiaries. Additionally, it directs the Inspector General to review predatory call center practices and report findings to Congress within one year. The bill directly affects Medicare agents, brokers, and TPMOs by reshaping regulatory oversight and enforcement.
The Telehealth Modernization Act extends Medicare telehealth flexibilities through 2027, allowing more patients to access care remotely without geographic restrictions. It expands who can provide telehealth services (including audio-only visits), extends telehealth use for hospice recertification, and updates coverage for in-home cardiopulmonary rehabilitation. The bill also extends "acute hospital care at home" program flexibilities through 2030 and requires a study on this program's effectiveness. Additionally, it includes provisions to improve telehealth access for patients with limited English proficiency and enhances Medicare coverage for virtual diabetes prevention programs. These changes primarily affect Medicare beneficiaries, healthcare providers, and telehealth service companies.
The REAL Health Providers Act (S 3750) requires Medicare Advantage plans to maintain accurate, up-to-date provider directories for beneficiaries, starting in 2028. Plans must verify provider information at least every 90 days (or annually for hospitals), remove outdated listings within 5 business days, and indicate when information may be inaccurate. If a beneficiary is treated by a provider listed in the directory but not in the network, the plan must cover costs as if the provider were in-network. Annual accuracy reports will be submitted by plans and publicly posted by the government starting in 2029.
This bill requires Medicare plans (including Medicare Advantage and prescription drug plans) to base coverage decisions on medical necessity and evidence-based standards. It mandates that plans seek input from practicing physicians when creating or changing coverage rules, post all preauthorization requirements online in plain language, and publicly share statistics on approvals and denials. The bill also requires that adverse coverage decisions be made by licensed, board-certified physicians and prohibits denying coverage solely due to lack of evidence-based standards when none exist for a service. These changes aim to reduce unnecessary delays in care for Medicare beneficiaries by increasing transparency and clinical input in coverage decisions.
This bill changes how Medicare Part D coinsurance is calculated for seniors. Starting in 2026, for drug costs above the deductible but below the out-of-pocket limit, coinsurance will be based on the drug's *net price* (the actual negotiated price after manufacturer discounts) instead of the list price. It directly affects Medicare Part D beneficiaries and prescription drug plans by requiring plans to use the net price when calculating these costs. The net price is defined as the discounted price reported in the Detailed DIR Report, excluding manufacturer discounts. This change aims to reduce out-of-pocket costs for seniors by aligning coinsurance with the lower price paid by the plan.
Stopping Addiction and Falls for the Elderly Act or the SAFE Act This bill incorporates risk assessments and prevention services for falls into annual wellness visits and initial preventive physical exams under Medicare, as well as associated services provided by physical therapists and occupational therapists.
