S. 2830: Wellness and Education for Longer Lives for Seniors Act of 2025

This bill, titled the Wellness and Education for Longer Lives for Seniors Act of 2025, aims to improve the annual wellness visit under the Medicare program. Here is a summary of its main provisions:

Improvements to Medicare Annual Wellness Visits

The bill proposes to enhance the existing Medicare annual wellness visit by:

• Adding new elements to the visit, such as screenings for balance to identify fall risks, and taking into consideration factors that affect health like mobility, food security, housing security, transportation access, and social support.
• These improvements will be effective starting January 1, 2026.

Incentive Payments

The legislation provides for additional financial incentives for healthcare providers who offer comprehensive annual wellness visits. Specifically:

• If a wellness visit includes certain specified elements, healthcare providers will receive an additional payment equivalent to 10% of the usual service payment.
• This provision aims to encourage providers to conduct more thorough wellness visits that could benefit patients.

Education and Outreach

The bill requires the Secretary of Health and Human Services to carry out educational activities to inform Medicare beneficiaries about the changes to the annual wellness visit. Key aspects include:

• Conducting a national outreach campaign aimed particularly at low-income beneficiaries, those in rural areas, and non-physician providers.
• Funding for these educational activities is authorized for the fiscal years 2026 through 2030.

Inclusion of Telehealth Services

The bill includes provisions for annual wellness visits to be considered part of telehealth services from January 1, 2026, expanding the accessibility of these services for Medicare beneficiaries.

Provider Eligibility and Inclusion of Other Healthcare Professionals

The amendments expand the types of providers eligible to perform wellness visits to include physical therapists, occupational therapists, and pharmacists, increasing the number of professionals who can provide these services.

Guidance and Standards

The Secretary is mandated to issue updated guidance related to follow-up processes for wellness visits to ensure adherence to personal prevention plans and referrals.

Research and Evaluation

The legislation requires a report analyzing the current use of annual wellness visits among Medicare beneficiaries. This includes:

• Data on the prevalence of such visits, especially those done via telehealth.
• Interviews with stakeholders to understand billing and utilization concerns.
• A focus group study to identify barriers to utilization and recommend enhancements.
• Funding is authorized for the necessary evaluations and studies through fiscal years 2026 to 2030.

Effective Dates

Most provisions in the bill will become effective starting January 1, 2026, setting a clear timeline for these changes to be implemented.

Relevant Companies

• UNH - UnitedHealth Group: As a major provider of Medicare Advantage plans, changes to the annual wellness visit could influence their service offerings and reimbursement structures.
• ANTM - Anthem, Inc: Similar to UnitedHealth, Anthem may need to adjust its plans and benefits structures to comply with new Medicare requirements.
• CNC - Centene Corporation: As a provider of government-sponsored healthcare, it could be impacted by changes in Medicare regulations and wellness visit protocols.