Social Security and Medicare

Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2025

This bill provides for Medicare coverage of dental, vision, and hearing care. Coverage includes (1) routine dental cleanings and exams, basic and major dental services, emergency dental care, and dentures; (2) routine eye exams, eyeglasses, and contact lenses; and (3) routine hearing exams, hearing aids, and exams for hearing aids. With respect to such care, the bill establishes special payment rules, limitations, and coinsurance requirements.

The bill also increases the Medicaid Federal Medical Assistance Percentage (i.e., federal matching rate) for dental, vision, and hearing services.

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.

Health Care Efficiency Through Flexibility Act

This bill requires the Centers for Medicare & Medicaid Services (CMS) to delay certain requirements relating to the reporting of quality measures by accountable care organizations (ACOs) under the Medicare Shared Savings Program and to also test alternative reporting methods for ACOs. (The Medicare Shared Savings Program enables ACOs to receive payments for savings stemming from care coordination and management.)

Specifically, the CMS must delay the requirement that ACOs use a specified electronic system for reporting quality measures until January 1, 2030. Additionally, the CMS must establish a pilot program to test other digital reporting methods; ACOs that participate in the pilot program are exempt from using the existing electronic system.

The CMS must also implement standards for digital reporting by January 1, 2030, that ensure all electronic health record systems used by ACOs are able to support reporting across a range of practice sizes, specialties, and geographic locations. ACOs may use existing reporting methods until the standards are implemented.

Freedom from Mandates Act

This bill nullifies certain executive orders regarding COVID-19 safety and prohibits the Departments of Labor and Health and Human Services (HHS) from taking specified actions with respect to vaccination against COVID-19.

Specifically, the bill nullifies Executive Order 14042 (relating to ensuring adequate COVID-19 safety protocols for federal contractors) and Executive Order 14043 (requiring COVID-19 vaccination for federal employees).

Labor may not issue any rule requiring employers to mandate vaccination of employees against COVID-19 or requiring testing of employees who are unvaccinated.

HHS may not (1) require a health care provider, as a condition of participation in the Medicare or Medicaid program, to mandate vaccination of employees against COVID-19 or require testing of employees who are unvaccinated; or (2) otherwise penalize such a provider for failure to mandate such vaccination or require such testing.

Medically Tailored Home-Delivered Meals Program Pilot Act

This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a temporary program through which certain Medicare beneficiaries with diet-impacted diseases may receive medically tailored meals at home to reduce their rate of hospital readmissions.

Specifically, the CMS must select, upon application, at least 40 hospitals to participate in a six-year program to deliver medically tailored meals to qualifying individuals' homes. Participating hospitals must meet specified program integrity and quality of care metrics and certify that they are able to provide the required meals and associated medical nutrition therapy. Hospitals must have a physician, registered dietitian or nutrition professional, advanced practice nurse, or clinical social worker screen inpatients upon discharge from the hospital and every 12 weeks thereafter to determine whether these individuals qualify for the meal program.

In order to qualify for the program, individuals must have a diet-impacted disease (e.g., kidney disease), live at home, not be receiving extended care services or hospice care, be limited with respect to at least two activities of daily living, and meet any other criteria for high-risk readmissions (as determined by the CMS).

Removing Medicare Mental Health Inpatient Limitations Act of 2026

This bill removes the 190-day lifetime limit on inpatient psychiatric hospital services under Medicare.

Clergy Act

This bill establishes a two-year window for certain members of the clergy and Christian Science practitioners to revoke their exemption from Social Security and Medicare taxes on ministerial earnings. Under current law, such individuals who object to participation in public insurance programs on religious or conscientious grounds may apply to the Internal Revenue Service for an irrevocable exemption and will not receive Social Security or Medicare benefits in retirement unless they have qualifying credits from other employment.

The Internal Revenue Service must develop a plan to inform members of the clergy and Christian Science practitioners of their eligibility to revoke prior exemptions, pursuant to the bill's changes.

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.

Medicare IVIG Access Enhancement Act of 2025

This bill provides for Medicare coverage of in-home administration of intravenous immune globulin to treat chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy. (CIDP is an autoimmune condition that causes symptoms such as muscle weakness and numbness; multifocal motor neuropathy is a variant of CIDP that only causes asymmetric muscle weakness.)

Reducing Drug Prices for Seniors Act

This bill requires the coinsurance amount for covered drugs under the Medicare prescription drug benefit to be based on the actual acquisition cost of the drug (i.e., the negotiated price under the prescription drug plan net of any manufacturer price concessions), rather than the wholesale acquisition cost of the drug, if the actual acquisition cost is lower.

Ending Improper Payments to Deceased People Act

This bill permanently allows the Department of the Treasury to access certain death records maintained by the Social Security Administration (SSA) in order to facilitate the identification and prevention of improper payments (e.g., payments to deceased individuals).

Current law requires the SSA to share its Death Master File with the Do Not Pay system maintained by Treasury for three years. The bill makes this requirement permanent.

Oversight of Medicare Billing Code Cost Act

This bill requires the Office of the Inspector General of the Department of Health and Human Services to report on the processes for adding, modifying, and removing billing codes under Medicare. The report must include recommendations for administrative and legislative changes that may improve the transparency and oversight of these processes.

In addition, the Centers for Medicare & Medicaid Services must annually publish on its website a list of billing codes that were added under Medicare during the previous year, as well as the associated volume and expenditures for such codes.

Save our Lone Emergency Services Act or the SOLES Act

This bill requires Medicare payments to sole community hospitals in Alaska or Hawaii to cover at least 94% of the reasonable costs of covered outpatient services.