“A bill to amend title XVIII of the Social Security Act to improve the annual wellness visit under the Medicare program.”
No CRS summary available for this bill.
This section improves Medicare Part B annual wellness visits (AWVs)—preventive services that include a health risk assessment and development of a personalized prevention plan—through several changes effective January 1, 2026, unless otherwise specified. Specifically, it (1) expands the required elements of an AWV to include assessments of mobility, food security, housing security, transportation access, social support, and other social determinants of health (in addition to the prior health status and nutrition review), and adds screening for balance to identify fall risk with appropriate referrals; (2) directs a 10% additional payment above the standard AWV amount for services furnished on or after January 1, 2026, that include the expanded social determinants element plus at least two others from specified AWV components, with coordination to avoid duplicating other add-on payments; (3) authorizes the Secretary of Health and Human Services to conduct education and outreach, including a national campaign within one year of enactment prioritizing low-income beneficiaries, non-physician providers, rural areas, and health professional shortage areas, with such sums as necessary appropriated for FY2026-FY2030; (4) designates AWVs as Medicare telehealth services on or after January 1, 2026; (5) expands eligible AWV providers to include physical therapists, occupational therapists, and pharmacists; (6) requires the Secretary to issue guidance within one year of enactment revising regulations on post-visit follow-up processes, oversight, and standards for health risk assessments, prevention plans, and referrals; and (7) directs the Centers for Medicare & Medicaid Services Administrator to issue a report within one year of enactment analyzing AWV prevalence and utilization over the prior 10 years (broken out by state, demographics, provider type, and Medicare fee-for-service vs. Advantage enrollment), telehealth use during the COVID-19 public health emergency, stakeholder interviews, and recommendations to increase use and effectiveness.