Health care costs

SUPPORT for Patients and Communities Reauthorization Act of 2025

This act reauthorizes and revises programs and activities relating to addressing substance use disorders, overdoses, and mental health. (For additional information on each section of this act, see CRS Report R48864.)

TITLE I--PREVENTION

(Sec. 101) This section reauthorizes through FY2030 Centers for Disease Control and Prevention (CDC) programs that provide information, grants, and technical assistance relating to studying and preventing prenatal and postnatal substance use disorders.

(Sec. 102) This section reauthorizes through FY2030 CDC programs that carry out and provide grants for surveillance, treatment, and education relating to infections associated with illicit drug use.

(Sec. 103) This section reauthorizes through FY2030 and expands CDC programs that carry out activities and provide grants relating to monitoring drug use and overdoses (e.g., supporting state prescription drug monitoring programs), preventing and responding to substance use disorders, and raising awareness regarding opioids and other substances.

The section authorizes additional activities, including wastewater surveillance and collecting data on risk factors associated with overdoses.

(Sec. 104) This section reestablishes, expands, and provides statutory authority for Department of Health and Human Services (HHS) activities addressing fetal alcohol spectrum disorders (i.e., conditions caused by prenatal alcohol exposure), including carrying out and providing grants for research, education and public awareness, and intervention and support services for affected individuals.

(Sec. 105) This section specifies that, in providing grants to support state prescription drug monitoring programs, the CDC is not authorized to require states to use specific vendors or interoperability systems other than to align with general, consensus-based standards for interoperability.

(Sec. 106) This section reauthorizes through FY2030 and expands grants to government entities to provide first responders with opioid overdose reversal drugs (e.g., naloxone) and related training. The grant program is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The section expands the program to include (1) treatment and training for overdoses from other drugs besides opioids, and (2) treatment with drugs or devices that are legally marketed under applicable law. Current law limits the program to addressing opioid overdoses and to drugs or devices that are officially approved or cleared by the Food and Drug Administration (FDA).

(Sec. 107) This section reauthorizes through FY2030 and revises the National Child Traumatic Stress Initiative and related activities, which are administered by SAMHSA. Under the initiative, SAMHSA provides grants and other support to improve the quality of and increase access to services addressing psychological trauma in youth and families.

The section requires grant recipients to develop training and other resources for collaborative implementation of best practices.

(Sec. 108) This section requires SAMHSA to undertake efforts to protect the 9-8-8 Suicide & Crisis Lifeline from cybersecurity threats. (The lifeline is a three-digit number that connects callers in suicidal crisis or mental health distress to a national network of crisis centers.) The section includes requirements for the lifeline’s network administrator and participating local and regional crisis centers to report identified cybersecurity incidents and vulnerabilities.

The Government Accountability Office must conduct a study that evaluates cybersecurity risks and vulnerabilities associated with the lifeline and report the findings to Congress.

(Sec. 109) This section reauthorizes through FY2030 CDC activities to collect and report certain public health data relating to potentially traumatic childhood experiences.

(Sec. 110) This section reauthorizes through FY2030 an interdepartmental committee on substance use disorders, establishes an interagency work group on fentanyl contamination of illegal drugs, and expands certain SAMHSA activities to include supporting strategies to raise awareness about the dangers of synthetic opioids for youth.

(Sec. 111) This section requires HHS to publish guidance regarding at-home safe drug disposal systems.

(Sec. 112) This section requires HHS to publish a plan for assessing approved opioid analgesic drugs (i.e., opioid pain relievers) that addresses the public health effects of these drugs, including updates on actions by the FDA with respect to risk-benefit assessments and supporting development and approval of nonaddictive medical products. HHS must provide an opportunity for public input on the FDA’s regulation of opioid analgesic drugs.

(Sec. 113) This section provides statutory authority for SAMHSA’s State Opioid Response and Tribal Opioid Response Grants to be used for facilitating access to drug checking technologies, such as fentanyl and xylazine test strips, to the extent permitted by federal and state law.

TITLE II--TREATMENT

(Sec. 201) This section reauthorizes through FY2030 the Residential Treatment for Pregnant and Postpartum Women program, which is administered by the Center for Substance Abuse Treatment within SAMHSA. This program awards grants to fund services for pregnant and postpartum women with substance use disorders, including services for treatment, recovery support, and case management.

The section also specifically allows grant recipients to conduct outreach that is targeted at women disproportionately impacted by maternal substance use disorders.

(Sec. 202) This section provides statutory authority for the Minority Fellowship Program to include fellowships for training in the field of addiction medicine. The Minority Fellowship Program, administered by SAMHSA, funds fellowships for individuals seeking graduate degrees and planning to work on addressing mental or substance use disorders in racial and ethnic minority populations.

(Sec. 203) This section reauthorizes through FY2030 the Behavioral Health Workforce Education and Training Program for Professionals, which is administered by the Health Resources and Services Administration (HRSA). This program provides grants to educational organizations and programs to recruit and educate students in mental and behavioral health.

(Sec. 204) This section reauthorizes through FY2030 the Substance Use Disorder Treatment and Recovery Loan Repayment Program, which is administered by HRSA. This program provides repayment of educational loans for health care practitioners who agree to provide direct treatment or recovery support for substance use disorders in certain areas with shortages of health professionals or high rates of overdose.

(Sec. 206) This section reauthorizes through FY2030 and expands an interagency task force that must develop recommendations relating to (1) best practices for preventing and mitigating trauma in youth and (2) coordinating the federal response to families impacted by substance use disorders and other trauma.

(Sec. 208) This section requires SAMHSA to conduct a review of how states use funds under the Community Mental Health Services Block Grant program to address first episode psychosis, including the use of evidence-based services for individuals with early serious mental illness and children with serious emotional disturbance. SAMHSA must report to Congress on the findings of the review and update the guidance for the block grant program based on such findings.

(Sec. 209) This section requires HHS to review relevant data and, if determined appropriate, request that the Drug Enforcement Administration (DEA) revise the scheduling of approved products containing a combination of buprenorphine and naloxone under the Controlled Substances Act. The DEA must review such requests and determine whether to revise the schedules.

(Sec. 210) This section requires that, when HHS issues new regulations or guidance on grant programs addressing opioid use disorders, references to an opioid overdose reversal drug (e.g., naloxone) must broadly include any opioid overdose reversal drug approved by the FDA.

Within one year after the act’s enactment, HHS must update all references accordingly in regulations or guidance issued prior to the act’s enactment that are applicable to State Opioid Response Grants, Tribal Opioid Response Grants, or certain other grants relating to substance use disorder prevention.

(Sec. 211) This section requires HHS to convene a public roundtable with public and private stakeholders on expanding the use of electronic health records among mental health and substance use disorder service providers. HHS must report to Congress on the results of the roundtable with respect to specified topics.

TITLE III--RECOVERY

(Sec. 301) This section reauthorizes through FY2030 the Building Communities of Recovery program, which is administered by the Center for Substance Abuse Treatment within SAMHSA. This program provides grants to certain community nonprofit organizations for developing and delivering coordinated community and statewide recovery support services for individuals with substance use disorders.

(Sec. 302) This section reauthorizes through FY2030 and expands the National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support, which is administered by SAMHSA. The center provides training and resources to public and private nonprofit entities relating to recovery support services for substance use disorders and co-occurring conditions (i.e., mental health conditions coexisting with substance use disorders).

The section expands the center's functions to include professional development of peer support specialists and recovery support services in nonclinical settings. It also authorizes through FY2030 a regional technical assistance center to support the ability of the center to meet a particular region's needs.

(Sec. 303) This section reauthorizes through FY2030 grants to nonprofits for establishing or operating opioid recovery centers providing comprehensive treatment and recovery support services. The grant program is administered by SAMHSA.

(Sec. 304) This section reauthorizes through FY2030 and revises the Preventing Youth Overdose: Treatment, Recovery, Education, Awareness, and Training (PYO-TREAT) program, which is administered by SAMHSA. The PYO-TREAT program provides grants and other support to educational and public entities for substance use disorder prevention, treatment, and recovery for children and young adults.

The section revises the program to provide statutory authority for (1) requiring applicants to submit plans for sustaining activities under the program after the grant has ended, and (2) expanding eligible grant recipients to include consortia of local educational agencies. SAMHSA must report to Congress on the PYO-TREAT program’s effectiveness.

(Sec. 305) This section reauthorizes through FY2030 and expands the Treatment, Recovery, and Workforce Support program, which is administered by SAMHSA. This program provides grants to public and private nonprofit entities to support individuals in treatment and recovery for substance use disorders and co-occurring conditions to live independently and participate in the workforce.

The section authorizes using 5% of such grant funds for transportation services and requires grant recipients to report on the employment and earnings outcomes of program participants.

Also, the section reauthorizes through FY2030 the Recovery Housing Pilot Program, which assists states in providing individuals in recovery from a substance use disorder with stable, temporary housing for up to two years. This program is administered by the Department of Housing and Urban Development.

(Sec. 306) This section reauthorizes through FY2030 the Support to Communities: Fostering Opioid Recovery through Workforce Development program, which is administered by the Department of Labor. This program provides grants to public entities to address the economic and workforce-related impacts of substance use disorders through activities such as screening and support services, training, and engaging with employers.

(Sec. 307) This section requires HHS to convene a public meeting relating to improving awareness of and access to grants provided by SAMHSA. Based on the stakeholder feedback received at the meeting, HHS must implement improvements to relevant websites and report to Congress.

TITLE IV--MISCELLANEOUS MATTERS

(Sec. 401) This section allows pharmacies to deliver to prescribing practitioners schedule III-V controlled substances that are not directly administered by the practitioner (i.e., self-administered), provided the controlled substances are subject to a risk evaluation and mitigation strategy to assure safe use by the patient, including post-administration monitoring by a health care provider.

(Sec. 402) This section expands the types of organizations that may provide training or education required for practitioners registering with the DEA to dispense (i.e., prescribe or administer) schedule II-V controlled substances. This section applies retroactively, taking effect as if enacted on December 29, 2022.

Putting Patients First by Strengthening Provider Accountability in FECA Act

This bill explicitly authorizes the Department of Labor to suspend payments under the federal workers’ compensation program to certain providers convicted of fraud. (Current regulations establish various grounds for excluding a provider from payment under the program, including a conviction for fraudulent activity in connection with a federal or state medical benefit program.)

Under the bill, Labor may suspend payments to a provider convicted of fraud related to the federal workers’ compensation program, a similar state program, or a federal health care benefit program (e.g., Medicare). Specifically, Labor may suspend (1) payments to such a provider for services, appliances, or supplies covered under the program; or (2) payments for certain initial expenses incurred by an employing agency with respect to such a provider.

Labor must issue regulations to carry out these provisions.

Do No Harm in Medicaid Act

This bill prohibits federal Medicaid payment for specified gender transition procedures for individuals under the age of 18. The bill defines these procedures to mean those that are intended to change the body of an individual to no longer correspond to the individual's biological sex (male or female), including specified surgeries, implants, and medications (e.g., hormones).

The bill excludes procedures that are provided to an individual under the age of 18 with the consent of a parent or legal guardian and that are intended to (1) rectify early puberty, genetic disorders, or chromosomal abnormalities; (2) reverse prior gender transition procedures; or (3) prevent imminent death or impairment of a major bodily function.

Give Kids a Chance Act of 2025

This bill expands the Food and Drug Administration’s (FDA’s) authority with respect to research on rare pediatric diseases, including by permitting the FDA to take enforcement action against drug sponsors that fail to satisfy pediatric study requirements and by reauthorizing programs that support pediatric research.

Specifically, the bill

• modifies requirements relating to molecularly targeted pediatric cancer investigations to permit research on new drugs in combination with active ingredients that have already been approved, provided certain conditions are met;

• permits the FDA to take enforcement action against drug sponsors that fail to comply with pediatric study requirements, if such sponsors demonstrated a lack of due diligence in satisfying the requirement;

• renews the FDA’s authority to award priority review vouchers to sponsors of new products intended to treat rare pediatric diseases through September 30, 2029; and

• reauthorizes through FY2027 certain funding for the National Institutes of Health to support priority pediatric research.

The bill also provides statutory authority for the FDA’s interpretation of the orphan drug exclusivity period. The bill specifies, consistent with FDA regulations, that the seven-year market exclusivity period for drugs for rare diseases or conditions (i.e., orphan drugs) prohibits the approval of the same drug for the same approved use or indication with respect to the disease or condition. (In Catalyst Pharmaceuticals, Inc. v. Becerra, a court rejected the FDA’s interpretation and held that orphan drug exclusivity extends to all uses or indications for the disease or condition.)

Protecting Veteran Access to Telemedicine Services Act of 2025

This bill permanently authorizes certain Department of Veterans Affairs (VA) health care professionals to use telemedicine to deliver, distribute, or dispense controlled substances that are prescription drugs to patients who are eligible for VA health care, regardless of whether the health care professional has conducted an in-person medical examination. The health care professional must be (1) authorized to prescribe the basic class of such controlled substance under an active, current, full, and unrestricted license or certification; (2) acting in the usual course of professional practice; and (3) delivering, distributing, or dispensing the substance for a legitimate medical purpose.

Rural Community Hospital Demonstration Program Reauthorization

This bill extends the Rural Community Hospital Demonstration Program for an additional five years. The program tests the feasibility of cost-based reimbursement under Medicare for small rural hospitals that are too large to qualify for special payment as critical access hospitals.

The bill specifies that hospitals that participate in the program between December 30, 2024, and January 1, 2027, may continue to participate during the five-year extension period.

Aviation Medication Transparency Act of 2025

This bill directs the Federal Aviation Administration (FAA) to compile, publish, and annually update a list of medications that may be safely prescribed to pilots and air traffic controllers for the purposes of issuing a medical certification. The list must be publicly available on the FAA website and distributed to those seeking a license and medical certification.

Currently, the FAA does not have a list of approved medications. However, the FAA does have lists for Aviation Medical Examiners of Do Not Issue medications and Do Not Fly medications.

Choices for Increased Mobility Act of 2025

This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish specific billing codes under Medicare for certain materials used in ultralightweight manual wheelchairs.

Specifically, the CMS must establish at least two billing codes for the base of the wheelchair, with at least one code for a base with titanium or carbon fiber construction material and at least one code for a base without these materials. Suppliers receive the same payment under Medicare for these wheelchairs as would otherwise apply, but may bill beneficiaries for any difference between the payment and the actual charge for the wheelchair. The CMS may require suppliers to inform beneficiaries of their potential financial liability in these cases.

Affordable Prescriptions for Patients Act

This bill limits in certain instances the number of patents that the manufacturer of a biologic drug can assert in a lawsuit against a company seeking to sell a biosimilar version of that drug. (A biologic drug is produced through natural processes or isolated from natural sources. A biosimilar version is substantially similar to the original biologic, which is the reference product, and is often marketed as a less expensive alternative.)

The bill's provisions apply to an existing framework that gives the biosimilar manufacturer an abbreviated path to Food and Drug Administration approval to sell the biosimilar. Specifically, if the biosimilar manufacturer completes certain actions under the framework, such as sharing certain information about its product with the reference product manufacturer, the bill limits the number of certain patents that the reference product manufacturer may assert in a lawsuit, such as patents that were filed more than four years after the reference product received market approval. The limit shall not apply to patents claiming certain methods for using the biologic drug.

The court in which the infringement lawsuit is filed may increase the limit if justice so requires or if there is good cause for the increase.

VA Hospital Inventory Management System Authorization Act

This bill authorizes the Department of Veterans Affairs (VA) to purchase or develop and implement a cloud-based information technology system for the Veterans Health Administration (VHA) to manage inventory. If the VA purchases or develops such a system, the VA must implement a pilot program at one VHA facility before implementing the system throughout the entire VA to determine whether the functions of the system are satisfactory.

Chronic Disease Flexible Coverage Act

This bill provides statutory authority for guidance from the Internal Revenue Service (IRS) that expands the types of preventive care that may be offered under a high deductible health plan (HDHP) without requiring a deductible or with a deductible below the minimum threshold.

Under current law, to be considered health savings account-eligible, an HDHP must have a deductible above a certain minimum threshold amount, which is adjusted annually. However, an HDHP may cover certain types of preventive care without requiring a deductible or with a deductible below the minimum threshold.

The IRS issued guidance expanding the types of preventive care that may be covered by an HDHP without requiring a deductible or with a deductible below the minimum threshold to include

• angiotensin converting enzyme inhibitors for individuals with congestive heart failure, diabetes, or coronary artery disease;

• anti-resorptive therapy for individuals with osteoporosis or osteopenia;

• beta-blockers for individuals with congestive heart failure or coronary artery disease;

• blood pressure monitors for individuals with hypertension;

• inhaled corticosteroids and peak flow meters for individuals with asthma;

• insulin and other glucose lowering agents, retinopathy screening, glucometers, and hemoglobin A1c testing for individuals with diabetes;

• international normalized ratio testing for individuals with liver disease or bleeding disorders;

• low-density lipoprotein testing for individuals with heart disease;

• statins for individuals with heart disease or diabetes; and

• selective serotonin reuptake inhibitors for individuals with depression.

The bill provides statutory authority for the IRS's guidance.

Indian Health Service Emergency Claims Parity Act

This bill extends from 72 hours to not less than 15 days the time period to notify the Purchased/Referred Care (PRC) program of emergency medical care received from a non-Indian Health Service (IHS) medical provider or at a non-IHS medical facility. This bill does not apply to individuals who are elderly or disabled, who continue to have a 30-day notification requirement for emergency services.

The IHS provides medical and dental services directly to American Indian and Alaska Native patients whenever possible. The PRC program pays for medical or dental care that is provided away from an IHS or tribal health care facility. The PRC program must be notified of requests for authorization of payment for health care services from a non-IHS provider.

Currently in emergency cases, the patient, an individual on behalf of the patient, or the medical care provider must, within 72 hours after the beginning of treatment for the condition or after admission to a health care facility, notify a PRC authorizing official of the need for the emergency medical care. This bill instead allows the patient, other individual, or provider to notify PRC not less than 15 days of the treatment or admission.

Indian Health Service Emergency Claims Parity Act

This bill extends from 72 hours to 15 days the time period to notify the Purchased/Referred Care (PRC) program of emergency medical care received from a non-Indian Health Service (IHS) medical provider or at a non-IHS medical facility. This bill does not apply to individuals who are elderly or disabled, who continue to have a 30-day notification requirement for emergency services.

The IHS provides medical and dental services directly to American Indian and Alaska Native patients whenever possible. The PRC program pays for medical or dental care that is provided away from an IHS or tribal health care facility. The PRC program must be notified of requests for authorization of payment for health care services from a non-IHS provider.

Currently in emergency cases, the patient, an individual on behalf of the patient, or the medical care provider must, within 72 hours after the beginning of treatment for the condition or after admission to a health care facility, notify a PRC authorizing official of the need for the emergency medical care. This bill instead allows the patient, other individual, or provider to notify PRC within 15 days of the treatment or admission.

This joint resolution nullifies the rule titled Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability, which was issued by the Centers for Medicare & Medicaid Services on June 25, 2025.

The rule makes several changes to enrollment requirements for health insurance exchanges, including (1) requiring annual open enrollment periods for all exchanges to begin by November 1 and end by December 31, (2) requiring all exchanges to conduct pre-enrollment verification of eligibility for at least 75% of new enrollments through special enrollment periods, and (3) prohibiting Deferred Action for Childhood Arrivals (DACA) recipients from enrolling in plans through exchanges or in state Basic Health Programs (state programs for certain low-income residents).

The rule also prohibits individual and small group health insurers from covering certain sex-trait modification procedures as an essential health benefit.

Health Care Freedom for Patients Act of 2025

This bill allows certain individuals with health savings accounts (HSAs) to receive federal payments. It also restricts payments under Medicaid and the Children's Health Insurance Program (CHIP) regarding certain noncitizens and restricts coverage of gender-transition procedures.

Specifically, the bill provides funds for the Department of Health and Human Services to deposit payments into an individual’s HSA during 2026-2027 if the individual has a bronze or catastrophic plan through a health insurance exchange, is between the ages of 18 and 64, and has income up to 700% of the federal poverty level (FPL). Individuals may receive $1,000 or $1,500 annually, depending on age.

The bill also provides funds, beginning in 2027, for cost-sharing reductions for certain individuals who have a silver plan and income up to 250% of the FPL.

Beginning in 2027, the bill allows any individual to enroll in a catastrophic plan. Currently, these plans are limited to those under the age of 30 or who have certain exemptions.

The bill also reduces the enhanced federal matching rate for the Medicaid expansion population in states that provide any health benefits for individuals who are not qualified aliens under federal law. The bill makes Medicaid and CHIP coverage of individuals while their status is being verified optional and conditions federal payment during this period on verification.

Finally, the bill prohibits exchange plans from covering gender-transition procedures as an essential health benefit and prohibits federal payment under Medicaid and CHIP for these procedures.

Lower Health Care Costs Act

This bill extends for three years, through 2028, temporary changes enacted by the American Rescue Plan Act of 2021 (ARPA) and the Inflation Reduction Act of 2022 (IRA) that generally expand eligibility for and increase the amount of the premium tax credit.

Currently, eligible taxpayers may be able to claim the premium tax credit, which applies toward the cost of obtaining health insurance through health insurance exchanges. To be eligible for the premium tax credit, a taxpayer’s household income must meet or exceed 100% of the federal poverty level (FPL) and, after 2025, may not exceed 400% of the FPL (maximum income limit). For 2021-2025, the ARPA and IRA eliminated the maximum income limit, which generally expands eligibility for the premium tax credit.

Further, under current law, the amount of the premium tax credit is (1) generally the plan premium (conditions apply), minus (2) the taxpayer’s household income multiplied by the applicable percentage. The applicable percentage is a specific percentage that varies depending on which of six income ranges (adjusted for inflation after 2025) the taxpayer’s household income falls within. For 2021-2025, the ARPA and IRA lowered the applicable percentages and eliminated the adjustment of the applicable percentages for inflation, which generally increases the amount of the premium tax credit.

The bill extends for three years, through 2028, the elimination of the 400% maximum income limit, the lower applicable percentages, and the elimination of the inflation adjustment for the applicable percentages.

Ensuring Community Access to Pharmacist Services Act

This bill provides for permanent coverage under Medicare of certain pharmacist services.

Specifically, the bill provides for permanent coverage of testing and treatment services provided by pharmacists relating to (1) COVID-19, influenza, respiratory syncytial virus (RSV), and streptococcal pharyngitis (strep throat); and (2) other public health needs in relation to a declared public health emergency. (Similar authorities were temporarily granted during the COVID-19 public health emergency.) Such services must be provided in accordance with the applicable state laws governing pharmacists' scope of practice.

Provider Reimbursement Stability Act of 2026

This bill allows for larger annual adjustments to the Medicare physician fee schedule. It also requires the Centers for Medicare & Medicaid Services (CMS) to make certain corrections to compensate for expenditures under the fee schedule that exceed a certain amount in a given year, and it limits how much certain adjustment factors may vary each year.

Current law prohibits annual adjustments to the Medicare physician fee schedule that would result in a more than $20 million difference between the adjusted amount and the non-adjusted amount of total expenditures. The bill increases this threshold to $54.3 million beginning in 2027, with adjustments for inflation every five years beginning in 2032.

Additionally, for certain services, the bill requires the CMS to determine the difference between expenditures based on estimated utilization of the service and expenditures based on actual utilization. If this difference exceeds a certain percentage of total expenditures under the fee schedule, the CMS must reconcile this difference by adjusting payments for the following year. This requirement applies to services for which payment was bundled with another service and there was a separate or add-on payment during the previous year.

Finally, the CMS must update the prices and rates of each category of direct costs that affect payments (e.g., prices of equipment) at least every five years, with updates made to each category in the same year. The bill also prohibits the CMS from varying a certain adjustment factor by more than 2.5% each year.

Ensuring Patient Access to Critical Breakthrough Products Act

This bill provides for Medicare coverage of medical devices that are approved under the Food and Drug Administration (FDA) Breakthrough Devices Program. (Under the program, manufacturers work with the FDA to expedite the review and approval of certain medical devices that provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating human diseases or conditions.)

The bill allows designated medical breakthrough devices to be temporarily covered under Medicare during a four-year transitional period. Manufacturers must apply to the Centers for Medicare & Medicaid Services (CMS) to receive this designation. Qualifying devices must (1) have received priority review from the FDA, (2) received premarket approval (if applicable) based on clinical data that includes data from Medicare beneficiaries, (3) already generally qualify for Medicare coverage, and (4) not present an undue risk of harm that outweighs potential clinical benefits for Medicare beneficiaries.

The CMS must approve or deny applications within six months of receipt and must provide an explanation in the case of a denial. In addition, the CMS must make permanent coverage decisions before the end of the transitional period upon a timely request to do so, as specified.

The bill provides funds through FY2030 for the CMS to implement the bill.

Living Donor Protection Act of 2025

This bill prohibits life insurance, disability insurance, and long-term insurance carriers from denying or otherwise restricting coverage for living organ donors.

Specifically, carriers may not deny, cancel, vary premiums, or otherwise impose conditions on policies based on an individual's status as a living organ donor.

The bill also expressly specifies that recovery from organ-donation surgery constitutes a serious health condition that entitles eligible employees to job-protected medical leave.

In addition, the Department of Health and Human Services must update educational materials on living organ donation to include information about the benefits and risks of living organ donation and the impact of donation on insurance access, particularly with respect to the bill's changes.