S.1996 - Medicare Audiology Access Improvement Act of 2025 (119th Congress)
Summary
The Medicare Audiology Access Improvement Act of 2025 (S.1996) aims to amend Title XVIII of the Social Security Act to improve Medicare coverage for audiology services. The bill seeks to expand access to audiology services by allowing qualified audiologists to furnish hearing and balance assessment and treatment services without requiring a physician's referral or supervision.
It also specifies payment amounts for audiology services, setting them at 80 percent of the lesser of the actual charge or the fee schedule amount. Furthermore, it includes qualified audiologists as practitioners in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
The amendments made by this bill would apply to items and services furnished on or after January 1, 2027.
Expected Effects
This bill will likely increase access to audiology services for Medicare beneficiaries. It will also empower audiologists by allowing them to provide a broader range of services independently.
This could lead to earlier detection and treatment of hearing and balance disorders. It may also reduce the burden on primary care physicians by allowing audiologists to directly address these specific healthcare needs.
Finally, the bill clarifies payment structures and ensures audiologists are recognized as qualified healthcare providers within specific healthcare settings.
Potential Benefits
- Increased access to audiology services for Medicare beneficiaries, particularly in rural and underserved areas.
- Greater autonomy for qualified audiologists to provide comprehensive hearing and balance care.
- Potential for earlier diagnosis and treatment of hearing loss and balance disorders, leading to improved health outcomes.
- Reduced burden on primary care physicians, allowing them to focus on other medical needs.
- Inclusion of qualified audiologists as recognized practitioners in RHCs and FQHCs, enhancing healthcare access in these settings.
Potential Disadvantages
- Potential for increased Medicare spending due to expanded coverage of audiology services.
- Possible concerns about the quality and appropriateness of care if audiologists operate without physician oversight (although the bill stipulates services must be within the scope of state law).
- The effective date of January 1, 2027, means there will be a delay before beneficiaries and audiologists can realize the benefits.
- The 80% payment rate may not be sufficient to cover the costs of providing audiology services, potentially limiting participation by audiologists.
- The bill includes a rule of construction that prevents expansion of audiology services beyond those payable as of December 31, 2026, which could limit future innovation and service development.
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution, as it aims to improve healthcare access for Medicare beneficiaries. The Constitution (Preamble) states the government should "promote the general Welfare".
Congress has the power to legislate on matters related to Medicare under its enumerated powers. Specifically, the bill amends Title XVIII of the Social Security Act, which falls under Congress's authority to regulate social welfare programs.
There are no apparent conflicts with individual liberties or states' rights in this bill. The bill does not infringe upon any specific constitutional rights.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).