Social Security and Medicare

Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025

This bill expands coverage of cardiac, intensive cardiac, and pulmonary rehabilitation programs under Medicare.

Specifically, the bill allows physician assistants, nurse practitioners, and clinical nurse specialists to administer these programs in their offices, prepare and sign treatment plans, and prescribe exercise.

Finn Sawyer Access to Cancer Testing Act

This bill provides for coverage of certain cancer diagnostic and laboratory tests under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Specifically, the bill provides for coverage of microarray analysis, DNA and RNA sequencing, whole-exome sequencing, and other next-generation sequencing for individuals diagnosed with cancer.

Additionally, the Department of Health and Human Services must establish an education and awareness program for physicians and the public about genomic testing and the role of genetic counselors.

Enhancing Native Elders' Longevity, Dignity, Empowerment, and Respect Act or the Native ELDER Act

This bill establishes a tribal advisory committee, revises certain grants, and requires reporting related to older (i.e., aged 60 or older) American Indians, Alaska Natives, and Native Hawaiians.

Specifically, the bill directs the Administration on Aging (AOA) to establish a tribal advisory committee to provide advice and guidance on matters relating to older Native Americans.

Additionally, the bill specifies that the technical assistance and training programs provided to grant recipients (e.g., tribal organizations providing supportive services) may include topics such as program management, data development and use, basic business skills, grant development, program and service innovations, and staff training and certification.

The bill directs the AOA, when making grants to tribal organizations to provide supportive services for older Native Americans, to prioritize organizations that will use these grants for necessary home modifications that will facilitate the ability of older Native Americans to remain at home.

The AOA must also report to Congress on (1) the feasibility of modeling the Native American Caregiver Support Program after the Program of Comprehensive Assistance for Family Caregivers, (2) the level of need for in-home services that include accessible home modifications for older Native Americans, and (3) the barriers to Indian tribes accessing programs for older Native Americans. This report must be made publicly available.

The Department of Labor must report to Congress on how recipients of funding under the Senior Community Service Employment Program are serving older Native Americans.

This joint resolution nullifies the rule titled Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies, which was issued by the Centers for Medicare & Medicaid Services on November 7, 2024.

The rule sets Medicare payment rates for 2025 for home health services, disposable negative pressure wound therapy (dNPWT) devices, and intravenous immune globulin (IVIG) items and services. It also specifies changes to reporting and participation requirements for providers of home health services and long-term care facilities under Medicare, including a requirement that long-term care facilities report additional data regarding acute respiratory illnesses.

This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish drug adherence guidelines for covered drugs under Medicare so as to achieve an adherence rate of 90%. The CMS must incorporate artificial intelligence and machine-learning technologies and promote generics and biosimilars when developing the guidance.

Social Security and Medicare Lock-Box Act

This bill establishes (1) in the Federal Old-Age and Survivors Insurance Trust Fund, a Social Security Surplus Protection Account; and (2) in the Federal Hospital Insurance Trust Fund, a Medicare Surplus Protection Account.

The Managing Trustee of each trust fund (in both cases, the Secretary of the Treasury) (1) must transfer the annual surplus of the trust fund to its respective account; and (2) may not invest the balance in the account until a law takes effect that authorizes, for amounts in the trust fund, an investment vehicle other than U.S. obligations.

The bill establishes in the executive branch a commission to study the most effective vehicles for investment of the trust funds, other than investments in the form of U.S. obligations.

No Patient Left Alone Act of 2025

This bill requires hospitals, as a condition of Medicare participation, to have certain written policies and procedures that provide for patient visitation rights and to inform patients of such rights, including any applicable restrictions.

Medicare Fraud Detection and Deterrence Act of 2025

This bill requires the Centers for Medicare & Medicaid Services (CMS) to deactivate the standard unique health identifiers of health care providers that are excluded from federal health care programs because of fraud, waste, or abuse.

The bill also requires (1) any data submitted by Medicare Advantage plans with respect to durable medical equipment, prosthetics or orthotics, laboratory tests, imaging tests, or home health services to include the standard unique health identifier of the associated provider or supplier; and (2) health care practitioners who are employed by or contract with telehealth companies to use a specialized claims modifier (developed by CMS) for Medicare telehealth services.

Preventing Medicare Telefraud Act

This bill establishes conditions for payment of certain telehealth services, laboratory tests, and durable medical equipment under Medicare.

Specifically, the bill conditions payment for certain high-cost laboratory tests and durable medical equipment that are ordered via telehealth on at least one in-person visit during the preceding six-month period. Additionally, practitioners must submit claims for separately billable telehealth services under the practitioner's unique national provider identification number.

Maintaining Innovation and Safe Technologies Act

This bill requires the Centers for Medicare & Medicaid Services (CMS) to issue guidance on payment requirements for certain remote monitoring devices (e.g., glucose monitors) under Medicare medical services. Specifically, the CMS must issue guidance on payment requirements for devices that use artificial intelligence components and that transmit information to health care providers.

Defense of Conscience in Health Care Act

This bill requires the Department of Health and Human Services (HHS) to issue a final rule on protecting statutory conscience rights in health care that is identical or equivalent to the rule titled Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, which was scheduled to take effect on July 22, 2019, but was vacated by courts.

Federal law generally prohibits discrimination based on conscience or religious beliefs with respect to federally funded health care programs, including prohibiting recipients of certain federal funding from requiring health care providers to take actions that they find religiously or morally objectionable (e.g., providing referrals for abortions).

In 2019, HHS issued a final rule revising the applicable regulations, including imposing certification and cooperation requirements, as well as establishing additional enforcement provisions and penalties. However, this rule was later vacated by federal courts and never took effect. In 2024, HHS issued another final rule that generally applied a pre-2019 enforcement framework while also maintaining certain aspects of the 2019 rule (e.g., specifically designating HHS' Office for Civil Rights as the entity with the authority to handle relevant complaints).

The bill requires HHS to reinstate the 2019 rule in its entirety.

Medicare Protection Act of 2025

This bill excludes the proceeds of a sale of an individual's principal residence from counting as income for purposes of determining the individual's premiums under Medicare medical services.

Preventing Hospital Overbilling of Medicare Act

This bill repeals certain exceptions to site-neutral payments with respect to Medicare payments to an off-campus outpatient department of a health care provider. It also requires providers to use separate, unique health identifiers when submitting a claim to a health insurance issuer for services provided at an off-campus outpatient department.

Social Security Enhancement and Protection Act of 2025

This bill increases certain Social Security benefits, expands Social Security payroll taxes, and makes other changes to the Social Security program.

Under current law, Social Security has a taxable maximum, which refers to the maximum amount of a worker's earnings that are subject to Social Security payroll taxes (set at $176,100 in 2025). Additionally, the taxable maximum serves as the maximum amount of earnings used to calculate a worker's Social Security benefits.

This bill phases out the taxable maximum so as to apply payroll taxes to all earnings by 2035, and it revises the method used to calculate a worker’s Social Security benefits to account for earnings in excess of the taxable maximum. The bill also gradually increases the Social Security payroll tax applicable to workers and employers from 6.2% to 6.5% over six years.

Other changes to benefits include establishing a new method to calculate benefits for lifetime low earners and increasing benefits for certain beneficiaries on account of long-term eligibility. In addition, an eligible child of a retired, disabled, or deceased worker may continue to receive benefits through age 26, provided the child is a full-time student in postsecondary school.

An increase in Social Security benefits under these provisions may not be treated as income for purposes of determining eligibility for benefits, or the amount of any benefits, under a federal program or a state or local program financed with federal funds.