H.R. 2610 — Protecting Options for Seniors Act of 2025

This section establishes, beginning with 2026 rates, an additional adjustment to the national per capita Medicare Advantage (MA) growth percentage under section 1853(c)(6) of the Social Security Act for applicable MA local areas (i.e., those where the weighted average hospital wage index increases by more than 20% compared to the prior year, or to 2024 for 2026). The adjustment equals the product of (1) the applicable percentage increase in the weighted average hospital wage index (calculated using the average IPPS area wage index weighted by Parts A and B payments to area hospitals) and (2) a weighting factor (total wage-adjusted payments to area hospitals under Medicare DME and IPPS, including DSH, divided by total Parts A and B payments attributable to the area, excluding certain innovation model payments); requires this adjustment to be taken into account in MA benchmark, cap, and base payment amount calculations under subsections 1853(c)(1), (k)(1)(B), and (n)(2)(E); and mandates benchmark neutrality (i.e., no change to the enrollment-weighted average applicable amount across all MA areas). (Thus, the adjustment compensates for sudden increases in local FFS spending—and thus MA benchmarks—due to hospital wage index reclassifications without increasing overall MA expenditures.)