I 
119TH CONGRESS 
1ST SESSION H. R. 2045 
To amend title XVIII of the Social Security Act to provide for coverage 
of dental, vision, and hearing care under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2025 
Mr. DOGGETT (for himself, Ms. ADAMS, Ms. ANSARI, Ms. BALINT, Ms. 
BARRAGA´N, Mrs. BEATTY, Mr. BEYER, Mr. BISHOP, Ms. BONAMICI, Mr. 
BOYLE of Pennsylvania, Mr. CARSON, Mr. CARTER of Louisiana, Mr. 
CASAR, Mr. CASTRO of Texas, Ms. CHU, Mr. CLEAVER, Mr. COHEN, Mr. 
CONNOLLY, Ms. CROCKETT, Mr. CUELLAR, Mr. DAVIS of Illinois, Ms. 
DEAN of Pennsylvania, Ms. DEGETTE, Mrs. MCCLAIN DELANEY, Ms. 
DELAURO, Mr. DELUZIO, Mr. DESAULNIER, Ms. DEXTER, Mrs. DIN-
GELL, Ms. ESCOBAR, Mr. ESPAILLAT, Mr. EVANS of Pennsylvania, Ms. 
LEGER FERNANDEZ, Mr. FIELDS, Ms. FRIEDMAN, Mr. FROST, Mr. 
GARAMENDI, Mr. GARCI´A of Illinois, Mr. GARCIA of California, Ms. GAR-
CIA of Texas, Mr. GOLDMAN of New York, Mr. GOTTHEIMER, Mr. GREEN 
of Texas, Mr. GRIJALVA, Mrs. HAYES, Ms. HOYLE of Oregon, Mr. 
HUFFMAN, Mr. JACKSON of Illinois, Ms. JACOBS, Ms. JAYAPAL, Mr. 
JOHNSON of Georgia, Ms. JOHNSON of Texas, Ms. KAPTUR, Mr. 
KHANNA, Mr. KRISHNAMOORTHI, Mr. LANDSMAN, Mr. LARSEN of Wash-
ington, Mr. LARSON of Connecticut, Ms. LEE of Pennsylvania, Ms. LEE 
of Nevada, Mr. LIEU, Ms. MCBRIDE, Ms. MCCLELLAN, Ms. MCCOLLUM, 
Mrs. CHERFILUS-MCCORMICK, Mr. MCGOVERN, Mr. MEEKS, Ms. MENG, 
Mr. MFUME, Ms. MOORE of Wisconsin, Mr. NADLER, Mr. NORCROSS, 
Ms. NORTON, Ms. OCASIO-CORTEZ, Ms. OMAR, Ms. PINGREE, Mr. 
POCAN, Ms. POU, Ms. PRESSLEY, Mrs. RAMIREZ, Mr. RASKIN, Ms. ROSS, 
Mr. RUIZ, Ms. SALINAS, Ms. SA´NCHEZ, Ms. SCANLON, Ms. SCHA-
KOWSKY, Mr. DAVID SCOTT of Georgia, Ms. SEWELL, Mr. SHERMAN, Ms. 
SHERRILL, Mr. SMITH of Washington, Mr. SOTO, Ms. STANSBURY, Mr. 
SWALWELL, Mr. TAKANO, Mr. THANEDAR, Mr. THOMPSON of Mis-
sissippi, Mr. THOMPSON of California, Ms. TITUS, Ms. TLAIB, Ms. 
TOKUDA, Mr. TONKO, Mr. TORRES of New York, Mrs. TRAHAN, Mr. 
VARGAS, Mr. VEASEY, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Ms. 
WATERS, Mrs. WATSON COLEMAN, Ms. WILLIAMS of Georgia, Ms. WIL-
SON of Florida, Mr. MCGARVEY, Mrs. FOUSHEE, Mrs. MCIVER, Ms. LOIS 
FRANKEL of Florida, and Mr. GOMEZ) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
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quently 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 provide 
for coverage of dental, vision, and hearing care under 
the Medicare program. 
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 ‘‘Medicare Dental, Vi-
sion, and Hearing Benefit Act of 2025’’. 
SEC. 2. DENTAL AND ORAL HEALTH CARE. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (II), by striking ‘‘and’’ 
after the semicolon at the end; 
(2) in subparagraph (JJ), by adding ‘‘and’’ 
after the semicolon at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(KK) dental and oral health services (as de-
fined in subsection (nnn));’’. 
(b) DENTAL
AND ORAL HEALTH SERVICES DE-
FINED.—Section 1861 of the Social Security Act (42 
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U.S.C. 1395x) is amended by adding at the end the fol-
lowing new subsection: 
‘‘Dental and Oral Health Services 
‘‘(nnn) The term ‘dental and oral health services’ 
means— 
‘‘(1) preventative and screening services, such 
as oral exams, dental cleanings, dental x-rays, and 
fluoride treatments; 
‘‘(2) basic dental services, such as tooth res-
torations, basic periodontics services, tooth extrac-
tions, and oral disease management services; 
‘‘(3) major dental services, such as major tooth 
restorations, major periodontics services, bridges, 
crowns, root canals, and extractions; 
‘‘(4) emergency dental care; and 
‘‘(5) other necessary services related to dental 
or oral health (as defined by the Secretary).’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)) is 
amended— 
(A) by striking ‘‘and’’ before ‘‘(GG)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (HH) with respect 
to dental and oral health services (as defined in 
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section 1861(lll)), the amount paid shall be the 
payment 
amount 
specified 
under 
section 
1834(aa)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m) 
is amended by adding at the end the following new 
subsection: 
‘‘(aa) PAYMENT AND LIMITS FOR DENTAL AND ORAL 
HEALTH SERVICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for dental and oral health services 
(as defined in section 1861(nnn)) shall be, subject to 
paragraph (3), the applicable percent (specified in 
paragraph (2)) of the lesser of the actual charge for 
the services or the amount determined under the 
payment basis determined under section 1848. 
‘‘(2) APPLICABLE PERCENT.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), except as provided in subparagraph 
(B), the applicable percent specified in this 
paragraph is— 
‘‘(i) with respect to services described 
in section 1861(nnn)(1) furnished during 
2026 or a subsequent year, 100 percent; 
and 
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‘‘(ii) with respect to services not de-
scribed in clause (i)— 
‘‘(I) for a year before 2027, 0 
percent; 
‘‘(II) for 2027, 30 percent; 
‘‘(III) for 2028, 60 percent; and 
‘‘(IV) for 2029 and each subse-
quent year, 80 percent. 
‘‘(B) SPECIAL RULE FOR CERTAIN LOW-IN-
COME
INDIVIDUALS.—For purposes of para-
graph (1), the applicable percent specified in 
this paragraph is, with respect to services fur-
nished to an individual who is a subsidy eligible 
individual (as defined in section 1860D– 
14(a)(3)), or who would be a subsidy eligible in-
dividual if the individual were enrolled in a pre-
scription drug plan or MA–PD plan— 
‘‘(i) with respect to services described 
in section 1861(nnn)(1), for 2026 and 
each subsequent year, 100 percent; and 
‘‘(ii) with respect to services not de-
scribed in clause (i), for 2027 and each 
subsequent year, 80 percent. 
‘‘(3) LIMITATIONS AND SECRETARIAL AUTHOR-
ITY.— 
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‘‘(A) FREQUENCY.—With respect to dental 
and oral health services that are— 
‘‘(i) routine dental cleanings, payment 
may be made under this part for only two 
such cleanings during a 12-month period; 
and 
‘‘(ii) routine exams, payment may be 
made under this part for only two such 
exams during a 12-month period. 
‘‘(B) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
ADDI-
TIONAL LIMITATIONS.—The Secretary may 
apply such other reasonable limitations on 
the extent to which dental and oral services 
are covered under this part, including 
through application of a prior authoriza-
tion requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of dental 
and oral health services to the extent that 
such modification is consistent with the 
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recommendations of the United States Pre-
ventive Services Task Force. 
‘‘(iii) AUTHORITY
TO
WAIVE
FRE-
QUENCY
LIMITATIONS.—Notwithstanding 
subparagraph (A), the Secretary may 
waive any frequency limitation under such 
subparagraph for an individual (or cat-
egory of individuals) if determined appro-
priate by the Secretary.’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(KK),’’ be-
fore ‘‘(3)’’. 
(e) DENTURES.— 
(1) IN
GENERAL.—Section 1861(s)(8) of the 
Social Security Act (42 U.S.C. 1395x(s)(8)) is 
amended— 
(A) by striking ‘‘(other than dental)’’ and 
inserting ‘‘(including dentures)’’; and 
(B) by striking ‘‘internal body’’. 
(2) 
SPECIAL
PAYMENT
RULES.—Section 
1834(a) of the Social Security Act (42 U.S.C. 
1395m(a)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(23) PAYMENT AND LIMITS FOR DENTURES.— 
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‘‘(A) IN GENERAL.—The payment amount 
under this part for dentures shall be, subject to 
subparagraph (C), the applicable percent (speci-
fied in subparagraph (B)) of the amount other-
wise payable for such dentures under this sec-
tion. 
‘‘(B) APPLICABLE
PERCENT.—For pur-
poses of subparagraph (A), the applicable per-
cent specified in this subparagraph is— 
‘‘(i) for a year before 2027, 0 percent; 
and 
‘‘(ii) for 2027 and each subsequent 
year, 80 percent. 
‘‘(C) LIMITATIONS AND SECRETARIAL AU-
THORITY.— 
‘‘(i) IN GENERAL.—Payment may be 
made under this part for an individual 
for— 
‘‘(I) not more than one full upper 
and one full lower denture once every 
five years; and 
‘‘(II) not more than one partial 
upper denture and one partial lower 
denture once every five years. 
‘‘(ii) SECRETARIAL AUTHORITY.— 
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‘‘(I) AUTHORITY TO APPLY ADDI-
TIONAL LIMITATIONS.—The Secretary 
may apply such other reasonable limi-
tations on the extent to which den-
tures are covered under this part, in-
cluding through application of a prior 
authorization requirement. 
‘‘(II) AUTHORITY
TO
MODIFY 
COVERAGE.—Notwithstanding 
any 
other provision of this title, if the Sec-
retary determines appropriate, the 
Secretary may modify the coverage 
under this part of dentures to the ex-
tent that such modification is con-
sistent with the recommendations of 
the United States Preventive Services 
Task Force. 
‘‘(III) AUTHORITY
TO
WAIVE 
FREQUENCY
LIMITATIONS.—Notwith-
standing clause (i), the Secretary may 
waive any frequency limitation under 
such clause for an individual (or cat-
egory of individuals) if determined ap-
propriate by the Secretary.’’. 
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(f) REPEAL OF GROUND FOR EXCLUSION.—Section 
1862(a) of the Social Security Act (42 U.S.C. 1395y) is 
amended by striking paragraph (12). 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2026. 
SEC. 3. VISION CARE. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section 
2, is further amended— 
(1) in subparagraph (JJ), by striking ‘‘and’’ 
after the semicolon at the end; 
(2) in subparagraph (KK), by adding ‘‘and’’ 
after the semicolon at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(LL) vision services (as defined in subsection 
(ooo));’’. 
(b) VISION SERVICES DEFINED.—Section 1861 of 
the Social Security Act (42 U.S.C. 1395x), as amended 
by section 2, is further amended by adding at the end the 
following new subsection: 
‘‘Vision Services 
‘‘(ooo) The term ‘vision services’ means— 
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‘‘(1) routine eye examinations and procedures 
performed (during the course of any eye examina-
tion) to determine the refractive state of the eyes; 
and 
‘‘(2) other necessary services related to eye and 
vision health (as defined by the Secretary).’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by section 2, is further amended— 
(A) by striking ‘‘and’’ before ‘‘(HH)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (II) with respect 
to vision services (as defined in section 
1861(mmm)), the amount paid shall be the 
payment 
amount 
specified 
under 
section 
1834(bb)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m), 
as amended by section 2, is further amended by add-
ing at the end the following new subsection: 
‘‘(bb) PAYMENT
AND LIMITS
FOR VISION SERV-
ICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for vision services (as defined in sec-
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tion 1861(ooo)) shall be, subject to paragraph (2), 
80 percent of the lesser of the actual charge for the 
services or the amount determined under the pay-
ment basis determined under section 1848. 
‘‘(2) LIMITATIONS AND SECRETARIAL AUTHOR-
ITY.— 
‘‘(A) FREQUENCY.—With respect to rou-
tine eye exams, payment may be made under 
this part for only one such exam during a 12- 
month period. 
‘‘(B) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
ADDI-
TIONAL LIMITATIONS.—The Secretary may 
apply other reasonable limitations on the 
extent to which vision services are covered 
under this part, including through applica-
tion of a prior authorization requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of vision 
services to the extent that such modifica-
tion is consistent with the recommenda-
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tions of the United States Preventive Serv-
ices Task Force. 
‘‘(iii) AUTHORITY
TO
WAIVE
FRE-
QUENCY
LIMITATIONS.—Notwithstanding 
subparagraph (A), the Secretary may 
waive any frequency limitation under such 
subparagraph for an individual (or cat-
egory of individuals) if determined appro-
priate by the Secretary.’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(LL),’’ after 
‘‘(2)(KK),’’ (as added by section 2). 
(e) SPECIAL PAYMENT RULES
FOR EYEGLASSES, 
CONTACT LENSES, AND LOW VISION DEVICES.—Section 
1834(a) of the Social Security Act (42 U.S.C. 1395m(a)), 
as amended by section 2, is further amended by adding 
at the end the following: 
‘‘(24) PAYMENT AND LIMITS FOR EYEGLASSES 
AND CONTACT LENSES.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for eyeglass lenses, eyeglass 
frames, and contact lenses shall be, subject to 
subparagraph (B), 80 percent of the amount 
otherwise payable for such eyeglass lenses, eye-
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glass frames, and contact lenses, respectively, 
under this section. 
‘‘(B) LIMITATIONS AND SECRETARIAL AU-
THORITY.— 
‘‘(i) IN GENERAL.—Subject to clause 
(iii), payment may be made under this part 
(other than for eyewear described in sec-
tion 1861(s)(8)) for an individual for— 
‘‘(I) not more than one pair of 
eyeglass lenses during any 12-month 
period in an amount not exceeding 
$100; 
‘‘(II) not more than one set of 
eyeglass frames during any 24-month 
period in an amount not exceeding 
$100; and 
‘‘(III) contact lenses, only to the 
extent that the sum of such payments 
for contact lenses does not exceed a 
limitation of $200 during any 24- 
month period beginning during the 
first year beginning at least six 
months after the date of the enact-
ment of this paragraph (or, beginning 
during a subsequent year, such limita-
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tion for a 24-month period beginning 
in the previous year increase by an 
appropriate inflation adjustment spec-
ified by the Secretary). 
‘‘(ii) SECRETARIAL AUTHORITY.— 
‘‘(I) AUTHORITY TO APPLY ADDI-
TIONAL LIMITATIONS.—The Secretary 
may apply such other reasonable limi-
tations on the extent to which eye-
glass lenses, eyeglass frames, and con-
tact lenses are covered under this 
part, including through application of 
a prior authorization requirement. 
‘‘(II) AUTHORITY
TO
MODIFY 
COVERAGE.—Notwithstanding 
any 
other provision of this title, if the Sec-
retary determines appropriate, the 
Secretary may modify the coverage 
under this part of eyeglass lenses, eye-
glass frames, and contact lenses to 
the extent that such modification is 
consistent with the recommendations 
of the United States Preventive Serv-
ices Task Force. 
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‘‘(III) AUTHORITY
TO
WAIVE 
FREQUENCY
LIMITATIONS.—Notwith-
standing clause (i), the Secretary may 
waive any frequency limitation under 
such clause for an individual (or cat-
egory of individuals) if determined ap-
propriate by the Secretary. 
‘‘(iii) UPDATE
OF
PAYMENT
LIMITS 
TO
ACCOUNT
FOR
INFLATION.—With re-
spect to eyeglass lenses and contact lenses 
furnished during 2027 or a subsequent 
year, the Secretary shall increase the dollar 
amounts in effect under this subparagraph 
for such year by the percentage change in 
the consumer price index for all urban con-
sumers (United States city average) for 
the 12-month period ending with June of 
the previous year. 
‘‘(25) PAYMENT AND LIMITS FOR LOW VISION 
DEVICES.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for low vision devices shall be 
80 percent of the amount otherwise payable for 
low vision devices under this section. 
‘‘(B) SECRETARIAL AUTHORITY.— 
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‘‘(i) AUTHORITY
TO
APPLY
LIMITA-
TIONS.—The Secretary may apply reason-
able limitations on the extent to which low 
vision devices are covered under this part, 
including through application of a prior 
authorization requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of low vi-
sion devices to the extent that such modi-
fication is consistent with the recommenda-
tions of the United States Preventive Serv-
ices Task Force. 
‘‘(C) LOW VISION DEVICE DEFINED.—In 
this paragraph, the term ‘low vision device’ 
means a device, prescribed by a physician, that 
magnifies, enhances, or otherwise augments or 
interprets visual images irrespective of the size, 
form, or technological features of such device 
and does not include ordinary eyeglasses or con-
tact lenses. In the previous sentence, the term 
‘ordinary eyeglasses or contact lenses’ means 
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lenses that are intended to fully correct visual 
acuity or fully eliminate refractive error.’’. 
(f) DEFINITION OF DURABLE MEDICAL EQUIPMENT 
TO INCLUDE EYEGLASSES, CONTACT LENSES, AND LOW 
VISION DEVICES.—Section 1861(n) of the Social Security 
Act (42 U.S.C. 1395x(n)) is amended— 
(1) by striking ‘‘and’’ before ‘‘eye tracking’’ and 
inserting a comma; and 
(2) by inserting ‘‘, and eyeglass lenses, low vi-
sion devices (as defined in section 1834(a)(25)), eye-
glass frames, and contact lenses’’ before ‘‘; except’’. 
(g) REPEAL OF GROUND FOR EXCLUSION.—Section 
1862(a)(7) of the Social Security Act (42 U.S.C. 
1395y(a)(7)) is amended by striking ‘‘, eyeglasses (other 
than eyewear described in section 1861(s)(8)) or eye ex-
aminations for the purpose of prescribing, fitting, or 
changing eyeglasses, procedures performed (during the 
course of any eye examination) to determine the refractive 
state of the eyes’’. 
(h) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2026. 
SEC. 4. HEARING CARE. 
(a) COVERAGE.— 
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(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)), as 
amended by sections 2 and 3, is further amended— 
(A) in subparagraph (KK), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (LL), by inserting 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(MM) audiology services (as defined in sub-
section (ll)(3)) and hearing services (as defined in 
subsection (ll)(5));’’. 
(2) HEARING
SERVICES
DEFINED.—Section 
1861(ll) of the Social Security Act (42 U.S.C. 
1395x(ll)) is amended— 
(A) in the subsection heading, by inserting 
‘‘; HEARING
SERVICES’’ after ‘‘AUDIOLOGY 
SERVICES’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(5) The term ‘hearing services’ means— 
‘‘(A) routine hearing exams and exams for 
hearing aids; and 
‘‘(B) other necessary services related to hearing 
health (as defined by the Secretary).’’. 
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(b) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by sections 2 and 3, is further amended— 
(A) by striking ‘‘and’’ before ‘‘(II)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (JJ) with respect 
to audiology services (as defined in section 
1861(ll)(3)) and hearing services (as defined in 
section 1861(ll)(5)), the amount paid shall be 
the payment amount specified under section 
1834(cc)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m), 
as amended by sections 2 and 3, is further amended 
by adding at the end the following new subsection: 
‘‘(cc) PAYMENT AND LIMITS FOR HEARING SERV-
ICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for audiology services (as defined in 
section 1861(ll)(3)) and hearing services (as defined 
in section 1861(ll)(5)), shall be, subject to para-
graph (2), 80 percent of the lesser of the actual 
charge for the services or the amount determined 
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under the payment basis determined under section 
1848. 
‘‘(2) SECRETARIAL AUTHORITY.— 
‘‘(A) 
AUTHORITY
TO
APPLY
LIMITA-
TIONS.—The Secretary may apply reasonable 
limitations on the extent to which audiology 
services and hearing services are covered under 
this part, including through application of a 
prior authorization requirement. 
‘‘(B) AUTHORITY TO MODIFY COVERAGE.— 
Notwithstanding any other provision of this 
title, if the Secretary determines appropriate, 
the Secretary may modify the coverage under 
this part of audiology services and hearing serv-
ices to the extent that such modification is con-
sistent with the recommendations of the United 
States Preventive Services Task Force.’’. 
(c) PAYMENT UNDER THE PHYSICIAN FEE SCHED-
ULE.—Section 1848(j)(3) of the Social Security Act (42 
U.S.C. 1395w–4(j)(3)), as amended by section 2(d), is 
further amended by inserting ‘‘(2)(MM),’’ before ‘‘(3)’’. 
(d) HEARING AIDS.— 
(1) REPEAL
OF
GROUND
FOR
EXCLUSION.— 
Section 1862(a)(7) of the Social Security Act (42 
U.S.C. 1395y(a)(7)), as amended by section 3(g), is 
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further amended by striking ‘‘, hearing aids or ex-
aminations therefor,’’. 
(2) DEFINITION OF DURABLE MEDICAL EQUIP-
MENT TO INCLUDE HEARING AIDS.—Section 1861(n) 
of the Social Security Act (42 U.S.C. 1395x(n)), as 
amended by section 3, is further amended by insert-
ing ‘‘hearing aids,’’ before ‘‘and eyeglass lenses’’. 
(3) SPECIAL
PAYMENT
RULES
FOR
HEARING 
AIDS.—Section 1834(a) of the Social Security Act 
(42 U.S.C. 1395m(a)), as amended by sections 2 
and 3, is further amended by adding at the end the 
following new paragraph: 
‘‘(26) PAYMENT
AND
LIMITS
FOR
HEARING 
AIDS.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for hearing aids shall be, sub-
ject to subparagraph (B), 80 percent of the 
amount otherwise payable for hearing aids 
under this section. 
‘‘(B) LIMITATIONS AND SECRETARIAL AU-
THORITY.— 
‘‘(i) IN GENERAL.—Payment may be 
made under this part for an individual for 
not more than one hearing aid per ear dur-
ing a 48-month period. 
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‘‘(ii) SECRETARIAL AUTHORITY.— 
‘‘(I) AUTHORITY TO APPLY ADDI-
TIONAL LIMITATIONS.—The Secretary 
may apply additional limitations on 
the extent to which hearing aids are 
covered under this part, including 
through application of a prior author-
ization requirement and through ap-
plication of criteria for a minimum 
level of hearing loss for coverage of an 
initial or replacement hearing aid. 
‘‘(II) AUTHORITY
TO
MODIFY 
COVERAGE.—Notwithstanding 
any 
other provision of this title, if the Sec-
retary determines appropriate, the 
Secretary may modify the coverage 
under this part of hearing aids to the 
extent that such modification is con-
sistent with the recommendations of 
the United States Preventive Services 
Task Force. 
‘‘(iii) AUTHORITY
TO
WAIVE
FRE-
QUENCY
LIMITATIONS.—Notwithstanding 
clause (i), the Secretary may waive any 
frequency limitation under such clause for 
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an individual (or category of individuals) if 
determined appropriate by the Secretary.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2026. 
SEC. 5. NONAPPLICATION OF COMPETITIVE ACQUISITION 
TO CERTAIN ITEMS. 
Section 1847(a)(2) of the Social Security Act (42 
U.S.C. 1395w–3(a)(2)) is amended— 
(1) by striking ‘‘and excluding’’ and inserting 
‘‘excluding’’; and 
(2) by inserting ‘‘, and excluding dentures, eye-
glass lenses, contact lenses, and hearing aids’’ before 
the period at the end. 
SEC. 6. INCLUSION OF AN ORAL HEALTH PROFESSIONAL 
ON THE UNITED STATES PREVENTIVE SERV-
ICES TASK FORCE. 
(a) IN GENERAL.—The first sentence of section 
915(a)(1) of the Public Health Service Act (42 U.S.C. 
299b–4(a)(1)) is amended by inserting ‘‘, including at 
least 1 oral health professional’’ before the period at the 
end. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply beginning on January 1 of the 
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first year beginning at least 6 months after the date of 
the enactment of this Act. 
Æ 
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