Sponsors (2)
The bill expands Medicare coverage and clarifies billing for implanted middle ear devices—improving access and lowering out-of-pocket costs for eligible beneficiaries—while increasing program spending and leaving a risk that CMS implementation rules could limit access or shift costs to some patients.
Medicare beneficiaries with severe hearing loss will have implanted active middle ear devices covered as prosthetics, reducing out-of-pocket costs for eligible recipients.
Hospitals and providers can bill Medicare for implanted active middle ear devices under clearer coverage rules, improving provider reimbursement, access to care, and care coordination for patients who need the devices.
Taxpayers and the Medicare Trust Fund may face higher spending if Medicare begins covering more implanted hearing devices, raising program costs unless offsets are identified.
Some Medicare beneficiaries could still incur costs or face delays if CMS implements narrow eligibility criteria or prior authorization requirements when operationalizing the coverage clarification.
Based on analysis of 2 sections of legislative text.
Introduced March 12, 2025 by Amy Klobuchar · Last progress March 12, 2025
Directs the Centers for Medicare & Medicaid Services (CMS) to issue a clarification within 60 days that implanted active middle ear hearing devices qualify as prosthetics and therefore are not barred from Medicare coverage by the statutory hearing aid exclusion. The bill adopts the existing regulatory definition of “prosthetic” (by reference to 42 C.F.R. § 414.202 or successor regulation) and does not appropriate funds or create new programs.