1 | 1 | | I |
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2 | 2 | | 119THCONGRESS |
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3 | 3 | | 1 |
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4 | 4 | | STSESSION H. R. 2757 |
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5 | 5 | | To amend title XVIII of the Social Security Act to improve coverage of |
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6 | 6 | | audiology services under the Medicare program, and for other purposes. |
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7 | 7 | | IN THE HOUSE OF REPRESENTATIVES |
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8 | 8 | | APRIL9, 2025 |
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9 | 9 | | Mr. B |
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10 | 10 | | ILIRAKIS(for himself, Mr. MULLIN, Mr. MORAN, and Mr. MASSIE) in- |
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11 | 11 | | troduced the following bill; which was referred to the Committee on En- |
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12 | 12 | | ergy and Commerce, and in addition to the Committee on Ways and |
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13 | 13 | | Means, for a period to be subsequently determined by the Speaker, in |
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14 | 14 | | each case for consideration of such provisions as fall within the jurisdic- |
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15 | 15 | | tion of the committee concerned |
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16 | 16 | | A BILL |
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17 | 17 | | To amend title XVIII of the Social Security Act to improve |
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18 | 18 | | coverage of audiology services under the Medicare pro- |
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19 | 19 | | gram, and for other purposes. |
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20 | 20 | | Be it enacted by the Senate and House of Representa-1 |
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21 | 21 | | tives of the United States of America in Congress assembled, 2 |
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22 | 22 | | SECTION 1. SHORT TITLE. 3 |
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23 | 23 | | This Act may be cited as the ‘‘Medicare Audiology 4 |
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24 | 24 | | Access Improvement Act of 2025’’. 5 |
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26 | 26 | | mprince on LAP1J3WLY3PROD with $$_JOB 2 |
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27 | 27 | | •HR 2757 IH |
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28 | 28 | | SEC. 2. COVERAGE OF AUDIOLOGY SERVICES UNDER THE 1 |
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29 | 29 | | MEDICARE PROGRAM. 2 |
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30 | 30 | | (a) I |
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31 | 31 | | NGENERAL.—Section 1861(s)(2) of the Social 3 |
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32 | 32 | | Security Act (42 U.S.C. 1395x(s)(2)) is amended— 4 |
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33 | 33 | | (1) in subparagraph (JJ), by striking the semi-5 |
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34 | 34 | | colon at the end and inserting ‘‘; and’’; and 6 |
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35 | 35 | | (2) by adding at the end the following new sub-7 |
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36 | 36 | | paragraph: 8 |
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37 | 37 | | ‘‘(KK) audiology services (as defined in sub-9 |
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38 | 38 | | section (ll)(3));’’; and 10 |
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39 | 39 | | (b) I |
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40 | 40 | | MPROVEDACCESS TOAUDIOLOGYSERVICES.— 11 |
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41 | 41 | | Paragraph (3) of section 1861(ll) of the Social Security 12 |
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42 | 42 | | Act (42 U.S.C. 1395x(ll)) is amended to read as follows: 13 |
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43 | 43 | | ‘‘(3) The term ‘audiology services’ means such hear-14 |
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44 | 44 | | ing and balance assessment services furnished on or before 15 |
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45 | 45 | | December 31, 2026, and beginning January 1, 2027, such 16 |
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46 | 46 | | diagnostic or treatment services furnished by a qualified 17 |
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47 | 47 | | audiologist which the qualified audiologist is legally au-18 |
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48 | 48 | | thorized to perform under State law (or the regulatory 19 |
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49 | 49 | | mechanism provided by State law), as would otherwise be 20 |
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50 | 50 | | covered if furnished by a physician or as incident to a phy-21 |
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51 | 51 | | sician’s service. A qualified audiologist shall be permitted 22 |
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52 | 52 | | to furnish such audiology services without regard to any 23 |
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53 | 53 | | requirement that the individual receiving such audiology 24 |
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54 | 54 | | services is under the care of (or referred by) a physician 25 |
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55 | 55 | | or other health care practitioner or that such services are 26 |
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57 | 57 | | mprince on LAP1J3WLY3PROD with $$_JOB 3 |
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58 | 58 | | •HR 2757 IH |
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59 | 59 | | furnished under the supervision of a physician or other 1 |
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60 | 60 | | health care practitioner.’’. 2 |
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61 | 61 | | (c) P |
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62 | 62 | | AYMENTAMOUNT ANDCOINSURANCE.—Section 3 |
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63 | 63 | | 1833(a)(1) of the Social Security Act (42 U.S.C. 4 |
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64 | 64 | | 1395l(a)(1)) is amended— 5 |
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65 | 65 | | (1) by striking ‘‘and’’ before (HH); and 6 |
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66 | 66 | | (2) by inserting the following before the semi-7 |
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67 | 67 | | colon: ‘‘and (II) with respect to audiology services 8 |
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68 | 68 | | furnished under section 1861(s)(2)(KK), the 9 |
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69 | 69 | | amounts paid shall be 80 percent of the lesser of the 10 |
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70 | 70 | | actual charge for the services or the fee schedule 11 |
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71 | 71 | | amount provided under section 1848’’. 12 |
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72 | 72 | | (d) P |
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73 | 73 | | AYMENT ON ASSIGNMENT-RELATEDBASIS.— 13 |
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74 | 74 | | Section 1842(b)(18)(C) of the Social Security Act (42 14 |
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75 | 75 | | U.S.C. 1395u(b)(18)(C)) is amended by adding at the end 15 |
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76 | 76 | | the following new clause: 16 |
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77 | 77 | | ‘‘(ix) A qualified audiologist (as de-17 |
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78 | 78 | | fined in section 1861(ll)(4)(B)).’’. 18 |
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79 | 79 | | (e) I |
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80 | 80 | | NCLUSION OF QUALIFIEDAUDIOLOGISTS AS 19 |
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81 | 81 | | RHC |
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82 | 82 | | AND FQHC P RACTITIONERS.—Section 20 |
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83 | 83 | | 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 21 |
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84 | 84 | | 1395x(aa)(1)(B)) is amended by inserting ‘‘by a qualified 22 |
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85 | 85 | | audiologist (as defined in subsection (ll)(4)(B)),’’ after 23 |
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86 | 86 | | ‘‘(as defined in subsection (hh)(1)),’’. 24 |
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88 | 88 | | mprince on LAP1J3WLY3PROD with $$_JOB 4 |
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89 | 89 | | •HR 2757 IH |
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90 | 90 | | (f) RULE OF CONSTRUCTION.—Nothing in the 1 |
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91 | 91 | | amendments made by this section shall be construed to 2 |
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92 | 92 | | expand the scope of audiologist services or services for 3 |
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93 | 93 | | which payment may be made to other providers under title 4 |
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94 | 94 | | XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 5 |
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95 | 95 | | beyond those services for which such payment may be 6 |
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96 | 96 | | made as of December 31, 2026. 7 |
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97 | 97 | | (g) E |
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98 | 98 | | FFECTIVEDATE.—The amendments made by 8 |
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99 | 99 | | this section shall apply to items and services furnished on 9 |
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100 | 100 | | or after January 1, 2027. 10 |
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101 | 101 | | Æ |
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103 | 103 | | mprince on LAP1J3WLY3PROD with $$_JOB |
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