Social Security and Medicare

Permanent Telehealth from Home Act

This bill permanently allows any site to serve as an originating site (i.e., the location of the beneficiary) for purposes of Medicare telehealth services, including a beneficiary's home.

Preserving Life-saving Access to Specialty Medicines in America Act or the PLASMA Act

This bill phases-in certain price adjustments for plasma-derived products under the Medicare prescription drug benefit's Manufacturer Discount Program.

Current law requires manufacturers of covered drugs under the Medicare prescription drug benefit to provide a 10% discount for covered drugs during the initial coverage phase (i.e., before a beneficiary reaches the out-of-pocket spending threshold) and a 20% discount during the catastrophic coverage phase (i.e., after a beneficiary reaches the out-of-pocket spending threshold).

The bill phases-in discounts for plasma-derived products over several years, starting with a 1% discount in 2026 for both the initial and catastrophic coverage phases, and ending with a 10% discount beginning in 2030 for the initial coverage phase and a 20% discount beginning in 2032 for the catastrophic coverage phase.

Hospice Recertification Flexibility Act

This bill extends until December 31, 2027, the ability of physicians and nurse practitioners to fulfill certain requirements for hospice care recertification under Medicare via telehealth.

Specifically, physicians and nurse practitioners may continue to fulfill the requirement of a face-to-face encounter with the hospice patient via telehealth. Such telehealth encounters must be identified with a specialized claims modifier for purposes of billing.

The bill's authorization does not apply (1) in areas in which there has been a moratorium for at least six months on the enrollment of new hospice programs under Medicare, Medicaid, or the Children's Health Insurance Program (CHIP) due to fraud, waste, or abuse; (2) to providers who are subject to enhanced oversight under Medicare, Medicaid, or CHIP; and (3) to practitioners who are not enrolled as Medicare providers and who have private contracts with Medicare patients that do not meet applicable opt-out requirements.

Health Equity and Rare Disease Act of 2025 or the HEARD Act of 2025

This bill establishes Department of Health and Human Services (HHS) grants and other initiatives to address rare diseases or conditions (e.g., those affecting less than 200,000 people in the United States) in racial and ethnic minority populations.

For example, to advance such purposes, the bill establishes within HHS

• grants to public and private nonprofit entities for data collection and public outreach,

• grants to health professions schools to improve health care and minority representation in research regarding rare diseases and conditions,

• grants to tribal epidemiology centers and tribal and urban Indian health centers for research regarding rare diseases and conditions in tribal communities,

• scholarships and educational loan repayment for medical school students who agree to work as health care professionals serving populations with rare diseases or conditions,

• initiatives to coordinate research and other activities across the National Institutes of Health, and

• public health awareness and education campaigns.

Also, the bill requires HHS to submit various reports to Congress on topics including (1) the federal government’s research and public health activities regarding rare diseases or conditions in minority populations, (2) regulatory barriers to treating rare diseases in Medicare beneficiaries of color, and (3) strategies for research and development of treatments for rare diseases or conditions that disproportionately impact minority populations.

Preserving Patient Access to Accountable Care Act

This bill extends through 2027 certain incentive payments for health professionals who participate in eligible alternative payment models under Medicare.

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.

This bill establishes community engagement requirements (i.e., work requirements) for certain adults under Medicaid.

Specifically, the bill requires individuals ages 18 through 65 to work, engage in community service, or participate in a work program (or a combination of these) for at least 80 hours per month. The bill prohibits federal payments for, and allows state Medicaid programs to disenroll, individuals who do not meet these requirements for three or more months in a year.

The requirements do not apply to individuals who are (1) physically or mentally unfit to work, (2) pregnant, (3) parents or caretakers of children or incapacitated individuals, (4) complying with work requirements for other federal programs, (5) participating in a drug or alcohol treatment and rehabilitation program, or (6) enrolled at least half-time in school.

This bill permanently removes in-person evaluation requirements for mental health telehealth services under Medicare.

Social Security Overpayment Relief Act

This bill prohibits the Social Security Administration from collecting overpayments made in error to Social Security or Supplemental Security Income recipients 10 or more years prior to the discovery of the error by the administration. This prohibition extends to the collection of funds directly from overpaid recipients and to the adjustment of future payments to those recipients.

Social Security Guarantee Act of 2025

This bill requires the Department of the Treasury to issue certificates to Social Security beneficiaries that guarantee them the full monthly benefit amount to which they are entitled and at least an annual cost-of-living increase to their benefits. It also provides additional mandatory funding for those benefits.

Currently, Social Security beneficiaries are entitled to their benefits, but benefits are primarily funded through a payroll tax (including assets derived from the tax held in reserve). Actuarial projections reported by the Social Security Board of Trustees indicate that in 2035 there will be insufficient tax revenue and reserved assets to cover the full amount of benefit payments.

Rural Health Care Access Act of 2025

This bill eliminates certain criteria that hospitals must meet in order to qualify as critical access hospitals that receive special payment under Medicare.

Specifically, the bill eliminates the requirement that a hospital must either (1) be located more than 35 miles (15 miles in mountainous regions or areas with only secondary roads) from another hospital, or (2) have been certified prior to January 1, 2006, by the state as a necessary provider of services in the area.