Medicare expands fall-prevention care for seniors, adding PT and OT services
H.R. 1171 — SAFE Act · Filed by Carol Miller (R-WV) · 51 cosponsors · Introduced Feb 10, 2025 · Referred to committee
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What it does
This bill expands Medicare's annual wellness visit and initial preventive physical exam to include falls risk assessments and fall prevention services delivered by physical therapists and occupational therapists for seniors who have fallen in the prior year. It takes effect January 1, 2026, and requires the Secretary of Health and Human Services to report annually to Congress on fall-related injuries and treatment in seniors aged 65+.
Why we flagged it
The bill's core mechanism is straightforward: it adds physical and occupational therapy services to two existing Medicare preventive benefit categories for fall-risk patients. This is a routine expansion of covered services, not a tax provision, deregulation, or narrow carve-out.
What the text implies
- The bill does not specify copay or coinsurance amounts for the new PT/OT services; Medicare's standard cost-sharing rules will apply, meaning some seniors may face out-of-pocket costs despite the preventive framing.
- No funding mechanism is specified; the bill assumes existing Medicare trust fund capacity to absorb the cost of additional PT/OT visits, which may require future appropriations or benefit adjustments.
The full analysis lists 3 implications of this text.
Who stands to gain
physical therapy providers; occupational therapy providers; Medicare Advantage insurers (if they capture utilization savings)