Hearing Device Coverage Clarification Act
- Bill Number
- H.R. 1921
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-03-06: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-05-20T08:08:29Z
AI-Generated Summary
Purpose
The Hearing Device Coverage Clarification Act (H.R. 1921) aims to ensure that fully implanted active middle ear hearing devices—surgically placed devices that help with hearing by stimulating the middle ear—are covered under Medicare as prosthetics, rather than being excluded like traditional hearing aids.
Key Provisions
- Short Title: The bill is titled the "Hearing Device Coverage Clarification Act."
- Coverage Clarification: Within 60 days of enactment, the Administrator of the Centers for Medicare & Medicaid Services (CMS) must issue a clarification stating that these fully implanted devices qualify as prosthetics and are exempt from Medicare's exclusion on hearing aid coverage (under section 1862(a)(7) of the Social Security Act, which generally bars payment for routine hearing aids and exams).
- Definition of Prosthetic: The term "prosthetic" is defined according to existing federal regulations (42 CFR 414.202), which describe prosthetics as devices replacing a missing body part or function, such as limbs or organs.
Significant Changes to Existing Law
- This bill does not create new laws but interprets and clarifies current Medicare rules to explicitly include fully implanted active middle ear devices as covered prosthetics.
- It overrides any prior ambiguity by directing CMS to exclude these devices from the hearing aid coverage ban, potentially broadening access without altering the underlying Social Security Act exclusion for non-implanted hearing aids.
Potential Impacts
- On Government Agencies: CMS will need to update guidance, policies, and possibly claims processing systems within a tight 60-day timeline, which could involve minimal administrative costs but ensure consistent application of benefits.
- On Citizens: Medicare beneficiaries with severe hearing loss who require these advanced, surgically implanted devices may gain easier access to coverage, reducing personal out-of-pocket expenses (which can exceed thousands of dollars for such implants) and improving health outcomes through better hearing restoration.
- On International Relations: No direct impacts, as this is a domestic healthcare policy focused on U.S. Medicare programs.
Main Stakeholders Affected
- Medicare Beneficiaries: Primarily older adults or those with disabilities needing middle ear implants for profound hearing loss.
- Healthcare Providers: Surgeons, audiologists, and hospitals that implant these devices, who may see increased procedure volumes due to assured reimbursement.
- Device Manufacturers: Companies producing active middle ear implants, benefiting from expanded market access under Medicare.
- CMS and Taxpayers: CMS handles implementation, while broader coverage could slightly increase federal Medicare spending, though targeted to a specific medical need.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens statutory interpretation by mandating CMS clarification, reducing potential disputes over device classification; aligns with existing regulatory definitions without conflicting with the Social Security Act's intent to exclude routine, non-surgical hearing aids.
- Constitutional: No significant issues, as it involves congressional authority over federal spending programs like Medicare and does not infringe on individual rights or state powers.
- Political: Introduced by bipartisan sponsors (Rep. Fischbach and Rep. Craig), it reflects targeted healthcare access reforms; referral to key committees (Energy and Commerce, Ways and Means) suggests focus on health policy and fiscal oversight, with potential for non-controversial passage if it addresses a niche gap in elder care.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Fischbach, Michelle [R-MN-7]
Cosponsors (4)
Rep. Craig, Angie [D-MN-2], Rep. Finstad, Brad [R-MN-1], Rep. Stauber, Pete [R-MN-8], Rep. Moore, Blake D. [R-UT-1]
Recent Actions
- 2025-03-06: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-03-06: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-03-06: Introduced in House
- 2025-03-06: Introduced in House
Bill Versions
- Hearing Device Coverage Clarification Act — issued 2025-03-06 — PDF (2 pages)