Social Security and Medicare

Prevent Interruptions in Physical Therapy Act of 2025

This bill allows a physical therapist to receive payment under Medicare for services provided to the physical therapist's patients by another physical therapist through a qualifying temporary arrangement, regardless of the geographic area or population served. Currently, physical therapists may only receive payment with respect to such arrangements for services provided in medically underserved, rural, or health professional shortage areas.

Promoting Access to Diabetic Shoes Act

This bill allows a nurse practitioner or physician assistant to fulfill documentation requirements for coverage, under Medicare, of special shoes for diabetic individuals. Under current law, such requirements may be satisfied only by a physician.

Assuring Medicare’s Promise Act of 2025

This bill increases the net investment tax for certain taxpayers and appropriates revenue from the net investment tax to the Federal Hospital Insurance Trust Fund (which finances Medicare Part A). The bill also requires the Internal Revenue Service (IRS) to issue additional guidance on the net investment tax.

The bill requires individuals with a modified adjusted gross income (MAGI) exceeding $400,000 ($500,000 for joint filers and $250,000 for married individuals filing separately), estates, and trusts to pay a tax of 3.8% on the greater of their specified net income or net investment income, subject to limitations. (Under current law, individuals with a MAGI exceeding $200,000 [or $250,000 for joint filers], estates, and trusts pay a 3.8% tax on net investment income.)

The bill defines specified net income by expanding the definition of net investment income to

• include gross income from any trade or business (unless subject to employment taxes), including interest, dividends, annuities, royalties, and rents;

• include net gain from the disposition of business property;

• eliminate the exclusion of income from the investment of working capital; and

• eliminate the exception related to certain active partnership or S corporation interests.

The bill also

• expands the net investment tax definition of a trade or business,

• disallows net operating losses in calculating net investment income,

• includes certain foreign-sourced income in net investment income, and

• requires the IRS to issue guidance on the treatment of certain corporate distributions for purposes of the net investment tax.

Alzheimer's Screening and Prevention Act or the ASAP Act

This bill provides for Medicare coverage of blood tests to screen for the early stages of Alzheimer’s disease or related dementias. Specifically, the bill provides for coverage of genomic sequencing blood or blood product tests, or other equivalent tests, that are approved by the Food and Drug Administration.

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.

Maintaining Investments in New Innovation Act

This bill requires drug products with genetically targeted technology to have had market approval for at least 11 years in order to qualify for the Medicare Drug Price Negotiation Program. (The program requires the Centers for Medicare & Medicaid Services to negotiate the prices of certain prescription drugs under Medicare beginning in 2026. Among other requirements, drugs must have had market approval for at least 7 years (for drug products) or 11 years (for biologics) to qualify for negotiation.)

Improving Access to Medicare Coverage Act of 2025

This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility (SNF) services. (Generally, individuals must have been an inpatient at a hospital for at least three days in order to qualify for SNF services. An individual's time spent under observation at a hospital for purposes of determining whether the individual should be admitted does not count towards this requirement.)

Close the Medigap Act of 2025

This bill (1) expands guaranteed issue rights with respect to Medigap policies (Medicare supplemental health insurance policies), (2) eliminates certain limitations on Medigap policies for newly eligible Medicare beneficiaries, and (3) modifies other provisions related to Medigap policies. (Guaranteed issue rights require that a policy be offered to any eligible applicant without regard to health status.)

Amputation Reduction and Compassion Act of 2025 or the ARC Act of 2025

This bill provides for coverage of peripheral artery disease screening tests without cost-sharing under Medicare and Medicaid for certain at-risk individuals. It also requires the development of certain educational programs, a payment model, and Medicare quality measures to reduce amputations relating to such disease.

Social Security Expansion Act

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

Specifically, the bill changes the way Social Security benefits are calculated by increasing the primary insurance amount applicable to average monthly earnings that fall below a specified amount, and increasing bend points for individuals who become eligible for Social Security after 2025. (Bend points are dollar amounts at which earnings are segmented for the purpose of calculating an individual’s primary insurance amount. The share of an individual’s earnings that are replaced by Social Security decreases at each escalating bend point.)

The bill also revises the method of calculating cost-of-living adjustments to account for the spending of individuals over the age of 62 and establishes a new minimum benefit for certain low earners. Further, the bill permits full-time students who are the children of deceased or disabled workers to collect Social Security or railroad retirement child’s benefits until they reach age 22.

With respect to taxes, the bill extends payroll taxes on wages, salaries, and self-employment earnings to income above $250,000. (In 2025, the maximum amount subject to Social Security payroll tax is $176,100.) The bill also increases the net investment income tax and subjects active trade or business income to this tax.

Finally, the bill combines the existing Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund into a single Social Security Trust Fund.

Medicare Audiology Access Improvement Act of 2025

This bill provides for Medicare coverage of certain audiology services. Specifically, the bill expands coverage to include diagnostic and treatment services that are furnished by audiologists and that would otherwise be covered if provided by a physician, including incidental services, regardless of whether such services are provided pursuant to a referral from, or under the supervision of, a physician or other health care practitioner.

Sustainable Cardiopulmonary Rehabilitation Services in the Home Act

This bill permanently allows services relating to cardiac rehabilitation programs, intensive cardiac rehabilitation programs, and pulmonary rehabilitation programs to be furnished via telehealth at a beneficiary's home under Medicare.

Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN Act

This bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs.

Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.

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.

Equitable 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.

Medicare Hearing Aid Coverage Act of 2025

This bill allows for Medicare coverage of hearing aids and related examinations.

The Government Accountability Office must study programs that provide assistance for hearing aids and related examinations for individuals with hearing loss.

Medicare Home Health Accessibility Act

This bill allows individuals to receive occupational therapy as a home health service under Medicare without the need for other services. Currently, individuals may only receive occupational therapy as a home health service if they first qualify for home health services based on other needs (e.g., physical therapy).