Medicare expands fall-prevention care for seniors starting 2026

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 function is to broaden Medicare coverage of falls-prevention services by including physical and occupational therapists in the annual wellness visit and initial preventive exam. This is straightforward preventive-care policy with no hidden mechanisms.

What the text implies

• Expands the scope of practitioners eligible to bill Medicare for preventive services, potentially increasing utilization and program costs if uptake is high among the 65+ population.
• Annual reporting requirement creates a data feedback loop that may drive future policy decisions on fall prevention, potentially expanding coverage further if trends show benefit.
• By tying falls-prevention services to prior-year fall history, the bill creates an incentive for seniors to report falls to their physicians, improving surveillance data but potentially increasing diagnosis coding.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Seniors who have fallen gain access to specialized fall-prevention assessment and services at no additional cost under Medicare, reducing injury risk and hospitalizations. The bill imposes no new restrictions on patient rights or access, and expands preventive care coverage for a vulnerable population.

Who stands to gain

• physical therapy providers
• occupational therapy providers
• Medicare Advantage insurers (if they capture efficiency gains)
• healthcare systems offering PT/OT services

Named in the bill

Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS), Medicare, Social Security Act Section 1861

Where it stands

4 cosponsors: 3 Democrats, 1 Republicans.

• Jul 31, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Jul 31, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”

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 11 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $1,402,051 in lobbying spend. A filing names 8 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.

Jim Justice, the sponsor, reported $34,750 in PAC receipts in the 2026 cycle.

• American Physical Therapy Association — $614,051 on 2 filings
• The American Occupational Therapy Association, Inc. (aota) — $378,000 on 2 filings
• Alliance for Physical Therapy Quality and Innovation — $160,000 on 2 filings
• International Trademark Association — $140,000 on 2 filings
• Alliance for Physical Therapy Quality and Innovation — $70,000 on 1 filing

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