I 
119TH CONGRESS 
1ST SESSION H. R. 2610 
To amend title XVIII of the Social Security Act to address significant under 
projection of MA local area growth due to wage index reclassification. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 2, 2025 
Ms. TENNEY (for herself, Mr. LANGWORTHY, Mr. TONKO, Mr. LAWLER, and 
Ms. STEFANIK) introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on En-
ergy and Commerce, 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 
A BILL 
To amend title XVIII of the Social Security Act to address 
significant under projection of MA local area growth 
due to wage index reclassification. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protecting Options for 
Seniors Act of 2025’’. 
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SEC. 2. ADDRESSING SIGNIFICANT UNDER PROJECTION OF 
MA LOCAL AREA GROWTH DUE TO WAGE 
INDEX RECLASSIFICATION. 
(a) LOCAL ADJUSTMENT METHOD AND APPLICA-
BILITY.—Section 1853(c) of the Social Security Act (42 
U.S.C. 1395w–23(c)) is amended— 
(1) in paragraph (1)— 
(A) in the text preceding subparagraph 
(A), by striking ‘‘and (7)’’ and inserting ‘‘, 
(6)(D), and (7)’’; and 
(B) in subparagraph (C)(v)(II), by insert-
ing ‘‘, taking into account any adjustment 
under paragraph (6)(D)’’ before ‘‘, but not’’; 
and 
(2) in paragraph (6)— 
(A) in the heading, by inserting ‘‘; LOCAL 
GROWTH
PERCENTAGE
ADJUSTMENT’’ after 
‘‘DEFINED’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(D) ADDITIONAL ADJUSTMENT FOR SIG-
NIFICANT UNDER PROJECTION OF LOCAL AREA 
GROWTH.— 
‘‘(i) IN
GENERAL.—Beginning with 
rates calculated for 2026, for purposes of 
computing rates for an MA payment area 
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and a year as described in paragraph (1), 
if such area is an applicable area described 
in clause (ii), the Secretary shall, with re-
spect to such area, increase the national 
per capita MA growth percentage deter-
mined under this paragraph for such year 
by the number of percentage points speci-
fied in clause (iii)(I) for such area and 
year. 
‘‘(ii) APPLICABLE
AREA.—For pur-
poses of clause (i), an applicable area de-
scribed in this clause is an MA local area 
with respect to which the weighted average 
hospital wage index in effect in such area 
for 2025 (or a subsequent year), as cal-
culated under clause (iv), increased by 
more than 20 percent as compared to the 
weighted average hospital wage index in ef-
fect in such area during the preceding year 
(as so calculated). 
‘‘(iii) 
LOCAL
GROWTH
PERCENT-
AGE.— 
‘‘(I) IN GENERAL.—For purposes 
of clause (i), with respect to an appli-
cable area described in clause (ii) and 
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a year, the number of percentage 
points specified in this clause is equal 
to the product of— 
‘‘(aa) the percentage cal-
culated under subclause (II) for 
the area and year, and 
‘‘(bb) the weighting factor 
calculated under subclause (III) 
for the area and year. 
‘‘(II) PERCENTAGE.—For pur-
poses of subclause (I), the percentage 
calculated under this subclause for an 
applicable area and a year is— 
‘‘(aa) for 2026, the percent-
age by which the weighted aver-
age hospital wage index in effect 
in the applicable area for such 
year, as calculated under clause 
(iv), increased as compared to 
the weighted average hospital 
wage index in effect in such area 
for 2024 (as so calculated); and 
‘‘(bb) for 2027 and each 
subsequent year, the percentage 
by which the weighted average 
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hospital wage index in effect in 
the applicable area for such year, 
as calculated under clause (iv), 
increased as compared to the 
weighted average hospital wage 
index in effect in such area dur-
ing the preceding year (as so cal-
culated). 
‘‘(III) WEIGHTING FACTOR.—For 
purposes 
of 
subclause 
(I), 
the 
weighting factor calculated under this 
subclause for an applicable area and a 
year is equal to— 
‘‘(aa) the total amount of 
payments made under sections 
1833(t) and 1886 to all area hos-
pitals in such area (including dis-
proportionate 
share 
payments 
made 
under 
section 
1886(d)(5)(F)) that were subject 
to adjustment for wage or labor 
costs, divided by 
‘‘(bb) the total amount of 
payments made under parts A 
and B of this title attributable to 
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the payment of claims for items 
and services furnished in such 
area, excluding any such pay-
ment attributable to a payment 
and service delivery model being 
tested under section 1115A, 
determined using payment informa-
tion with respect to the most recent 
calendar year for which information 
was computed and published under 
subsection (b)(4), as of the date on 
which the advance notice under sub-
section (b)(2) is provided for the year. 
‘‘(iv) WEIGHTED AVERAGE HOSPITAL 
WAGE INDEX.—The weighted average hos-
pital wage index in effect in an MA local 
area for a year is equal to the average area 
wage 
index 
applicable 
under 
section 
1886(d)(3)(E) for all area hospitals for 
such area as of the date on which the ad-
vance notice under subsection (b)(2) is 
provided for the year, weighted by the total 
amount of payments made under parts A 
and B of this title to each such area hos-
pital, determined using payment informa-
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tion with respect to the most recent cal-
endar year for which information was com-
puted and published under subsection 
(b)(4), as of such date. 
‘‘(v) AREA
HOSPITAL
DEFINED.—In 
this subparagraph, the term ‘area hospital’ 
means, with respect to an MA local area 
and a year, a hospital that is geographi-
cally located in such area at any point dur-
ing such year (without regard to whether 
such hospital was reclassified to a new geo-
graphic 
area 
pursuant 
to 
section 
1886(d)(8)(B), a decision of the Medicare 
Geographic Classification Review Board 
under section 1886(d)(10), or a decision of 
the Secretary). 
‘‘(vi) REQUIREMENT OF BENCHMARK 
NEUTRALITY.—Any 
adjustment 
made 
under this subparagraph for an MA pay-
ment area and a year shall be made in a 
manner that ensures that the enrollment- 
weighted average applicable amount under 
subsection (k)(1)(B) for all MA payment 
areas and such year is not greater or less 
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than what it would have been without such 
adjustment.’’. 
(b) ADJUSTING
THE BENCHMARK CAP.—Section 
1853(k)(1)(B)(i) of the Social Security Act (42 U.S.C. 
1395w–23(k)(1)(B)(i)) is amended by inserting ‘‘, taking 
into account any adjustment under subparagraph (D) of 
such subsection’’ before ‘‘, but not’’. 
(c) ADJUSTING THE BASE PAYMENT AMOUNT.—Sec-
tion 1853(n)(2)(E)(ii) of the Social Security Act (42 
U.S.C. 1395w–23(n)(2)(E)(ii)) is amended— 
(1) in subclause (I), by inserting ‘‘, taking into 
account any adjustment under subparagraph (D) of 
such subsection’’ before ‘‘, but not’’; and 
(2) in subclause (II), by inserting ‘‘or, in the 
case that the area is an applicable area (as deter-
mined under subsection (c)(6)(D)), the amount spec-
ified in subclause (I) or the amount specified in sub-
section (c)(1)(D) for the area for the year, whichever 
is greater’’ before the period at the end. 
(d) TRANSPARENCY AND DATA SHARING.— 
(1) IN GENERAL.—Section 1853(b)(4) of the 
Social Security Act (42 U.S.C. 1395w–23(b)(4)) is 
amended by adding at the end the following new 
subparagraph: 
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‘‘(E) Total amount paid to each area hos-
pital (as defined in subsection (c)(6)(D)) for 
the year, computed separately for part A and 
for part B.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply beginning with the 
computation and publication of information for each 
MA payment area for 2026. 
Æ 
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