Medicare Audiology Access Improvement Act of 2025
- Bill Number
- H.R. 2757
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-04-09: 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
- 2026-07-07T08:05:34Z
AI-Generated Summary
Purpose
The Medicare Audiology Access Improvement Act of 2025 aims to enhance Medicare coverage for audiology services by allowing qualified audiologists to provide certain hearing and balance assessments and treatments directly to beneficiaries, without needing a physician's referral or supervision. This expands access to these services under Medicare Part B (the part covering outpatient care) starting in 2027.
Key Provisions
- Coverage Expansion: Adds audiology services to the list of Medicare-covered outpatient services. Until December 31, 2026, this includes hearing and balance assessments. Starting January 1, 2027, it covers diagnostic and treatment services that qualified audiologists are legally allowed to perform under state law, as long as they would be covered if provided by a physician.
- Direct Access: Qualified audiologists can deliver these services independently, without requiring the patient to be under a physician's care, referred by a doctor, or supervised by another healthcare provider.
- Payment Structure: Medicare pays 80% of the lower of the actual charge or a set fee schedule amount (similar to payments for physician services). Beneficiaries pay the remaining 20% as coinsurance. Payments can be made directly to audiologists who accept Medicare assignment (agreeing to the set fee).
- Inclusion in Clinics: Qualified audiologists are recognized as allowable practitioners in Rural Health Clinics (RHCs, community-based primary care for rural areas) and Federally Qualified Health Centers (FQHCs, safety-net providers for underserved populations).
- Limitations: The law does not broaden the types of audiology services Medicare covers beyond what is already payable to other providers as of December 31, 2026.
- Effective Date: Applies to services provided on or after January 1, 2027.
Significant Changes to Existing Law
- Previously, Medicare covered audiology services only if furnished by or under the supervision of a physician, limiting direct access for audiologists.
- This bill removes those physician oversight requirements, enabling standalone billing and provision by audiologists.
- It integrates audiologists into RHC and FQHC payment systems, which were not explicitly included before.
- Payment rules are aligned with standard Medicare Part B fees, but specifically tailored for audiology without prior equivalents for independent audiologist services.
Potential Impacts
- On Citizens: Medicare beneficiaries, particularly older adults (over 65) who often experience hearing loss, gain easier access to timely audiology care, potentially improving quality of life and reducing delays in diagnosis or treatment. This could lower out-of-pocket costs for those previously needing physician involvement.
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) will need to update fee schedules, billing systems, and provider enrollment processes to accommodate independent audiologists, possibly increasing administrative workload and Medicare expenditures for these services.
- On International Relations: No direct impacts, as this is a domestic healthcare policy focused on U.S. Medicare.
- Broader Effects: May encourage more audiologists to participate in Medicare, addressing shortages in hearing care, but could raise overall program costs without specified budget offsets.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary users, especially those with hearing or balance issues, who benefit from expanded access.
- Qualified Audiologists: Gain professional recognition, direct reimbursement, and ability to serve patients independently, potentially increasing their practice viability.
- Physicians and Healthcare Providers: May see reduced involvement in routine audiology referrals, shifting some workload but not eliminating collaboration.
- Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): Can now include audiologists as billable practitioners, enhancing service offerings in underserved areas.
- Centers for Medicare & Medicaid Services (CMS): Responsible for implementation, including rulemaking and oversight.
- State Governments: Involved indirectly through state laws defining audiologist scopes of practice.
Notable Legal, Constitutional, or Political Implications
- Legal: Aligns Medicare with state-authorized audiologist practices, potentially reducing legal disputes over supervision requirements. The "rule of construction" clause prevents unintended expansions of coverage, maintaining fiscal boundaries under existing Medicare law (Title XVIII of the Social Security Act).
- Constitutional: No apparent challenges; it operates within Congress's authority to regulate interstate commerce and social welfare programs like Medicare.
- Political: Introduced with bipartisan sponsorship (Republicans Bilirakis, Mullin, Moran, and Massie), suggesting broad support for improving senior healthcare access. Referred to key committees (Energy and Commerce, Ways and Means), indicating focus on health policy and budget implications, but no controversial elements like mandates or funding cuts are evident.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Bilirakis, Gus M. [R-FL-12]
Cosponsors (38)
Rep. Mullin, Kevin [D-CA-15], Rep. Moran, Nathaniel [R-TX-1], Rep. Massie, Thomas [R-KY-4], Rep. Gottheimer, Josh [D-NJ-5], Rep. Webster, Daniel [R-FL-11], Rep. Van Drew, Jefferson [R-NJ-2], Rep. Crow, Jason [D-CO-6], Rep. Sherrill, Mikie [D-NJ-11], Rep. Cohen, Steve [D-TN-9], Rep. Schakowsky, Janice D. [D-IL-9], Rep. Latimer, George [D-NY-16], Rep. Neguse, Joe [D-CO-2], Rep. Green, Al [D-TX-9], Rep. Vindman, Eugene Simon [D-VA-7], Rep. Davis, Donald G. [D-NC-1], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Letlow, Julia [R-LA-5], Rep. Johnson, Julie [D-TX-32], Rep. Bacon, Don [R-NE-2], Rep. McClain Delaney, April [D-MD-6], Rep. Grothman, Glenn [R-WI-6], Rep. Bynum, Janelle S. [D-OR-5], Rep. Ross, Deborah K. [D-NC-2], Rep. Craig, Angie [D-MN-2], Rep. Valadao, David G. [R-CA-22], Rep. Harder, Josh [D-CA-9], Rep. Moore, Blake D. [R-UT-1], Rep. Pingree, Chellie [D-ME-1], Rep. Loudermilk, Barry [R-GA-11], Rep. Costa, Jim [D-CA-21], Rep. Rutherford, John H. [R-FL-5], Rep. Pocan, Mark [D-WI-2], Rep. Chu, Judy [D-CA-28], Rep. Edwards, Chuck [R-NC-11], Rep. Rulli, Michael A. [R-OH-6], Rep. Steube, W. Gregory [R-FL-17], Rep. Thompson, Glenn [R-PA-15], Rep. Cammack, Kat [R-FL-3]
Recent Actions
- 2025-04-09: 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.
- 2025-04-09: 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.
- 2025-04-09: Introduced in House
- 2025-04-09: Introduced in House
Bill Versions
- Medicare Audiology Access Improvement Act of 2025 — issued 2025-04-09 — PDF (4 pages)