II 

118TH CONGRESS 

1ST SESSION S. 2942 

To amend title XVIII of the Social Security Act to improve the annual 

wellness visit under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 27 (legislative day, SEPTEMBER 22), 2023 

Mr. KING introduced the following bill; which was read twice and referred to 

the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to improve 

the annual wellness visit under the Medicare program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Wellness and Edu5 cation for Longer Lives for Seniors Act of 2023’’ or the 

6 ‘‘WELL Seniors Act of 2023’’. 

7 SEC. 2. IMPROVEMENTS TO THE MEDICARE ANNUAL 

8 WELLNESS VISIT. 

9 (a) ADDITIONAL ELEMENTS.— 


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1 (1) IN GENERAL.—Section 1861(hhh)(2) of the 

2 Social Security Act (42 U.S.C. 1395x(hhh)(2)) is 

3 amended— 

4 (A) in subparagraph (F), by striking ‘‘and 

5 nutrition’’ and inserting ‘‘nutrition, mobility, 

6 food security, housing security, transportation 

7 access, social support, and other social deter8 minants of health as determined by the Sec9 retary’’; 

10 (B) by moving subparagraphs (G) and (H) 

11 2 ems to the left; 

12 (C) by redesignating subparagraph (I) as 

13 subparagraph (J); and 

14 (D) by inserting after subparagraph (H) 

15 the following new subparagraph: 

16 ‘‘(I) Screening for balance to identify risk 

17 for falls and referral for treatment as appro18 priate.’’. 

19 (2) EFFECTIVE DATE.—The amendments made 

20 by paragraph (1) shall apply to items and services 

21 furnished on or after January 1, 2024. 

22 (b) INCENTIVE PAYMENTS.—Section 1833 of the So23 cial Security Act (42 U.S.C. 1395l) is amended by adding 

24 at the end the following new subsection: 


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1 ‘‘(ee) INCENTIVE PAYMENTS FOR ANNUAL

2 WELLNESS VISITS THAT INCLUDE CERTAIN ELE3 MENTS.— 

4 ‘‘(1) IN GENERAL.—In the case of personalized 

5 prevention plan services (as defined in paragraph (1) 

6 of section 1861(hhh)) that are furnished on or after 

7 January 1, 2024, and that include the element de8 scribed in subparagraph (F) of paragraph (2) of 

9 such section 1861(hhh) and at least 2 additional ele10 ments described in subparagraphs (A) through (E) 

11 and (G) through (J) of such paragraph (2), in addi12 tion to the amount of payment that would otherwise 

13 be made for such personalized prevention plan serv14 ices under this part, there also shall be paid an 

15 amount equal to 10 percent of the payment amount 

16 for the service under this part. 

17 ‘‘(2) COORDINATION WITH OTHER PAY18 MENTS.—The amount of the additional payment for 

19 a service under this subsection and subsection (m) 

20 shall be determined without regard to any additional 

21 payment for the service under subsection (m) and 

22 this subsection, respectively. The amount of the ad23 ditional payment for a service under this subsection 

24 and subsection (z) shall be determined without reVerDate Sep 11 2014 21:42 Oct 01, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2942.IS S2942

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1 gard to any additional payment for the service under 

2 subsection (z) and this subsection, respectively.’’. 

3 (c) EDUCATION AND OUTREACH.— 

4 (1) IN GENERAL.—The Secretary of Health and 

5 Human Services (in this section referred to as the 

6 ‘‘Secretary’’) shall conduct education and outreach 

7 activities regarding the coverage of annual wellness 

8 visits under the Medicare program, including 

9 changes to such visits under the amendments made 

10 by subsections (a) and (b). 

11 (2) NATIONAL OUTREACH CAMPAIGN.—Not 

12 later than 1 year after the date of enactment of this 

13 Act, the Secretary shall conduct a national outreach 

14 campaign to educate beneficiaries on the annual 

15 wellness visit under the Medicare program. In con16 ducting such outreach campaign, the Secretary may 

17 prioritize education and outreach to low-income 

18 beneficiaries, non-physician providers, and to pro19 viders working and beneficiaries living in rural areas 

20 or health professional shortage areas. 

21 (3) AUTHORIZATION OF APPROPRIATIONS.— 

22 There is authorized to be appropriated for fiscal 

23 years 2024 through 2028 such sums as may be nec24 essary to carry out this subsection. 


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1 (d) INCLUSION AS TELEHEALTH SERVICE.—Section 

2 1834(m)(4)(F)(i) of the Social Security Act (42 U.S.C. 

3 1395m(m)(4)(F)(i)) is amended by adding at the end the 

4 following new sentence: ‘‘Such term includes, with respect 

5 to telehealth services furnished on or after January 1, 

6 2024, an annual wellness visit (as defined in section 

7 1861(hhh)).’’ 

8 (e) PROVIDER ELIGIBILITY.— 

9 (1) IN GENERAL.—Section 1861(hhh)(3) of the 

10 Social Security Act (42 U.S.C. 1395x(hhh)(3)) is 

11 amended: 

12 (A) by striking ‘‘or’’ at the end of subpara13 graph (B); 

14 (B) by redesignating subparagraph (C) as 

15 subparagraph (D); and 

16 (C) by inserting after subparagraph (B) 

17 the following new subparagraph: 

18 ‘‘(C) a physical therapist, an occupational 

19 therapist, or a pharmacist; or’’. 

20 (2) EFFECTIVE DATE.—The amendments made 

21 by paragraph (1) shall apply to items and services 

22 furnished on or after January 1, 2024. 

23 (f) GUIDANCE REVISION.—Not later than 1 year 

24 after the date of enactment of this Act, the Secretary shall 

25 issue guidance amending section 410.15 of title 42, Code 


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1 of Federal Regulations, (or any successor regulations) to 

2 include guidance on processes, oversight, and standards 

3 for the post-visit follow-up to ensure consistency and com4 pliance with the Health Risk Assessment, personalized 

5 prevention plan, and referrals. 

6 (g) RESEARCH AND EVALUATION.— 

7 (1) REPORT.— 

8 (A) IN GENERAL.—Not later than 1 year 

9 after the date of enactment of this Act, the Sec10 retary, acting through the Administrator of the 

11 Centers for Medicare & Medicaid Services (in 

12 this subsection referred to as the ‘‘Adminis13 trator’’), shall analyze and publish a report on 

14 the prevalence in use of the annual wellness 

15 visit as defined under section 1861(hhh) of the 

16 Social Security Act (42 U.S.C. 1395x(hhh)) by 

17 Medicare beneficiaries, including current prac18 tices and recommendations for increasing the 

19 use and effectiveness of the annual wellness 

20 visit under the Medicare program under title 

21 XVIII of the Social Security Act (42 U.S.C. 

22 1395 et seq.). Such report shall include— 

23 (i) information regarding the inter24 views conducted under subparagraph (B); 


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1 (ii) data on the prevalence of annual 

2 wellness visits furnished to Medicare bene3 ficiaries via telehealth during the COVID– 

4 19 public health emergency; 

5 (iii) utilization and claims data for an6 nual wellness visits over the preceding 10 

7 years broken down by State, demographic 

8 groups (including age, race, ethnicity, in9 come, and education), the type of provider 

10 furnishing the annual wellness visit, and 

11 whether the beneficiary is enrolled for ben12 efits under the original Medicare-fee-for13 service program under parts A and B of 

14 title XVIII of the Social Security Act or 

15 the Medicare Advantage program under 

16 part C of title XVIII of the Social Security 

17 Act. 

18 (B) INTERVIEWS WITH STAKEHOLDERS.— 

19 The Administrator shall conduct interviews with 

20 stakeholders, including provider groups, on 

21 their concerns regarding billing for and using 

22 the annual wellness visit under the Medicare 

23 program, including whether and to what extent 

24 personalized prevention plan services and ap25 propriate referrals and follow-up are taking 


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1 place for beneficiaries who are at particular risk 

2 and which referral models are most effective. 

3 (2) FOCUS GROUP STUDY.—Not later than 6 

4 months after the date of enactment of this Act, the 

5 Secretary, acting through the Administrator, shall 

6 conduct a focus group study among providers, com7 munity-based organizations, and beneficiaries to8 wards increasing use of the annual wellness visit by 

9 Medicare beneficiaries. The Secretary shall work 

10 with beneficiary and stakeholder groups to develop 

11 the interview questions for such focus group study, 

12 and shall include questions on— 

13 (A) improving referrals to community serv14 ices; 

15 (B) barriers to utilization and rec16 ommendations to increase uptake; and 

17 (C) the types of providers in practices that 

18 furnish the visits. 

19 (3) AUTHORIZATION OF APPROPRIATIONS.— 

20 There is authorized to be appropriated for fiscal 

21 years 2024 through 2028 such sums as may be nec22 essary to carry out this subsection. 

Æ 


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