Medicare expands direct access to therapists and audiologists

What it does

This bill amends Medicare law to expand the types of healthcare providers that Medicare beneficiaries can choose directly, without physician referral. It adds therapists (physical, occupational, and speech-language pathologists) and qualified audiologists to the list of practitioners Medicare patients can select independently. The change applies across multiple sections of Medicare's payment and coverage rules, systematically replacing references to 'physician' with 'physician, practitioner, therapist, or qualified audiologist' to ensure consistent access.

Why we flagged it

The bill's core function is to broaden Medicare beneficiary choice by allowing direct access to therapists and audiologists without physician gatekeeping. This is a straightforward regulatory amendment to expand patient autonomy within the Medicare system.

What the text implies

• Removing physician referral requirements may increase utilization of therapy and audiology services, potentially raising Medicare spending if demand-side barriers were previously constraining volume.
• Therapists and audiologists may gain market share from physician-directed referral patterns, shifting revenue flows within the healthcare sector.
• Direct-access provisions could incentivize these practitioners to expand capacity and marketing to Medicare beneficiaries, changing competitive dynamics in rehabilitation and hearing-aid markets.
• The bill does not address reimbursement rates or quality oversight mechanisms for direct-access providers, leaving potential gaps in cost control or outcome accountability.

Who it affects

Medicare beneficiaries gain direct access to a broader range of healthcare providers without requiring a physician referral, reducing administrative barriers and expanding choice. This may lower out-of-pocket costs and improve care coordination for patients needing therapy or audiology services.

Who stands to gain

• physical therapy providers
• occupational therapy providers
• speech-language pathology providers
• audiology practices
• hearing aid manufacturers and distributors

Named in the bill

Medicare, Social Security Act Section 1802, Section 1861, physical therapists, occupational therapists, speech-language pathologists, qualified audiologists, BMY (Bristol Myers Squibb), GH (Guardant Health), PFE (Pfizer), DVA (DaVita), JNJ (Johnson & Johnson)

Where it stands

6 cosponsors: 3 Democrats, 3 Republicans.

• Jun 26, 2025 — Introduced · Congress.gov: “Introduced in House”
• Jun 26, 2025 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

6 lobbying clients named this bill on 12 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $1,888,101 in lobbying spend. A filing names 16 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 82% of bills with at least one filing.

Lloyd Smucker, the sponsor, reported $853,756 in PAC receipts in the 2026 cycle.

• American Speech-language-hearing Association — $680,000 on 2 filings
• American Physical Therapy Association — $614,051 on 2 filings
• The American Occupational Therapy Association, Inc. (aota) — $378,000 on 2 filings
• American Chiropractic Association — $126,050 on 2 filings
• American Society of Hand Therapists — $50,000 on 2 filings

Lobbying Disclosure Act filings through Jul 19, 2026. A filing shows who paid to lobby on a bill it names, not what changed.