What does Preamble of Protecting Options for Seniors Act of 2025 do?

This bill proposes to amend title XVIII of the Social Security Act. The stated purpose is to address significant under projection of Medicare Advantage (MA) local area growth. This under projection is attributed to wage index reclassification.

What does SHORT TITLE. of Protecting Options for Seniors Act of 2025 do?

This bill is formally titled the Protecting Options for Seniors Act of 2025.

What does ADDRESSING SIGNIFICANT UNDER PROJECTION OF MA LOCAL AREA GROWTH of Protecting Options for Seniors Act of 2025 do?

This section amends Section 1853(c) of the Social Security Act to address significant underprojection of local area growth due to wage index reclassification. It introduces a new subparagraph (6)(D) that allows for an increase in the national per capita MA growth percentage for applicable areas. An 'applicable area' is defined as an MA local area where the weighted average hospital wage index increased by more than 20 percent compared to the previous year. The increase in the growth percentage is calculated based on the percentage of wage index increase and a weighting factor. The weighting factor is determined by comparing total payments to area hospitals for wage/labor cost adjustments to total payments under parts A and B. The amendments also adjust the benchmark cap and base payment amount to take into account these adjustments. Section 1853(b)(4) is amended to require the publication of the total amount paid to each area hospital for both parts A and B.

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Protecting Options for Seniors Act of 2025

Last updated: 4/2/2025 · Introduced: 4/2/2025

Author: Claudia Tenney (R-NY)

TL;DR (AI)

The bill modifies Medicare Advantage (MA) growth calculations to account for areas experiencing significant wage index increases, potentially increasing payments to those areas.
It establishes a formula to determine an increased national per capita MA growth percentage for 'applicable areas' based on hospital wage index changes and payment weighting.
The bill mandates the public disclosure of payments to area hospitals for wage/labor cost adjustments under Medicare Parts A and B.

119th Congressin committeeOfficial page

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Includes provisions on preamble, short title., and 1 more.

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