To provide coverage for dental and oral health care, hearing care, and vision care under the Medicare program.

SA 5211. Mr. SANDERS (for himself and Mr. Merkley) proposed an
amendment to amendment SA 5194 proposed by Mr. Schumer to the bill H.R.
5376, to provide for reconciliation pursuant to title II of S. Con.
Res. 14; as follows:

At the end of subtitle B of title I, add the following:

PART 6--MEDICARE COVERAGE OF DENTAL AND ORAL HEALTH CARE, HEARING CARE,
AND VISION CARE

Subpart A--Medicare Coverage

SEC. 11501. INTERIM DENTAL PROGRAM.

Title XVIII of the Social Security Act (42 U.S.C. 1395 et
seq.) is amended by inserting after section 1866F the
following new section:

``SEC. 1866G. INTERIM DENTAL PROGRAM.

``(a) Establishment.--The Secretary shall establish an
interim Medicare dental program (in this section referred to
as the `program') by not later than 6 months after the date
of the enactment of this section. Under the program, payment
shall be made for eligible expenses of eligible beneficiaries
in accordance with this section.
``(b) Amount.--The Secretary shall pay for eligible
expenses under the program per eligible beneficiary in an
amount not to exceed $1,000.
``(c) Program Implementation.--
``(1) In general.--The Secretary shall--
``(A) make a Treasury-sponsored account described in
paragraph (2)(A)(i) available to eligible beneficiaries so
payment may be made to entities described in subsection
(d)(2)(B) for eligible expenses at the point-of-sale;
``(B) issue cards for making payments described in
subparagraph (A), and replacement cards for cards that are
lost or stolen; and
``(C) provide a toll-free telephone number and website to
answer beneficiary questions on the program including the
amount available for payment.
``(2) Payments.--
``(A) Delivery of payments.--
``(i) In general.--The account through which the Secretary
shall make payment for eligible expenses under the program
shall be deemed to be a Treasury-sponsored account, as
defined in section 208.2 of title 31, Code of Federal
Regulations, without regard to section 913 of the Electronic
Fund Transfer Act (15 U.S.C. 1693k), section 1005.10(e)(2) of
title 12, Code of Federal Regulations (or any successor
regulation), section 1(d) of Executive Order 13681 (31 U.S.C.
3321 note; relating to improving the security of consumer
financial transactions), section 3332(i) of title 31, United
States Code, and subchapter IV of chapter 33 of title 31,
United States Code.
``(ii) Treatment of accounts.--The Department of the
Treasury shall be deemed to be the customer of any financial
institution for any account issued under clause (i) for
purposes of the Right to Financial Privacy Act (12 U.S.C.
3401 et seq.).
``(B) Authorized transactions.--
``(i) Condition of acceptance of payment.--Acceptance of
payment under subparagraph (A)(i) shall be deemed to be an
agreement by the entity accepting such payment to furnish
such information as may be necessary for the Secretary to
verify that such payment is for eligible expenses of an
eligible beneficiary.
``(ii) Review.--The Secretary shall review payments, as
necessary, to verify transactions are for eligible expenses
of eligible beneficiaries.
``(C) Requirement.--Notwithstanding the provisions of
section 1(d) of Executive Order 13681, cards issued under
paragraph (1)(B) shall be magnetic stripe-only cards that do
not utilize chip and PIN technology.
``(3) Expediting implementation.--The Secretary shall
implement the program through program instruction.
``(4) Administration.--The requirements under section
1862(b) (relating to secondary payer) and section 1882(d)(3)
(relating to non-duplication of health benefits) are waived.
The Secretary shall not impose sanctions under subsection
1877(g) with respect to designated health services that are
eligible expenses.
``(5) Nonapplication of medicaid third party liability.--
Neither the program nor an entity receiving payment for
eligible expenses under the program shall be treated as a
legally liable party for purposes of applying section
1902(a)(25).
``(d) Definitions.--In this section:
``(1) Eligible beneficiary.--The term `eligible
beneficiary' means an individual who--
``(A) is enrolled under part B; and
``(B) as of the start of the program, or in the case of an
individual who enrolls in part B after the date that is 6
months after the date of the enactment of this section, the
first month in which the individual is enrolled under such
part, is not subject to a reduction in premium subsidy
pursuant to section 1839(i).
``(2) Eligible expenses.--The term `eligible expenses'
means expenses for which payment has not been made by
insurance or a party other than the beneficiary, for dental
items and services furnished to an eligible beneficiary that
are--
``(A) to the extent applicable, treated as medical care
under section 213(d)(1)(A) of the Internal Revenue Code of
1986;
``(B) furnished by entities such as those with merchant
category code 8021 (or successor codes); and
``(C) presented for payment on or after the date of the
activation of the card described in subsection (c)(1)(B), and
ending on December 31, 2024.
``(3) Program.--The term `program' means the program
established under this section.
``(e) Outreach and Education.--
``(1) In general.--The Secretary shall provide outreach and
education on the program--
``(A) for eligible beneficiaries; and
``(B) for entities described in subsection (d)(2)(B).
``(2) Funding.--In addition to amounts otherwise available,
there is appropriated to the Secretary for fiscal year 2022,
out of amounts in the Treasury not otherwise appropriated,
$82,000,000, to remain available until December 31, 2025, to
carry out this subsection.
``(f) No Impact on Benefits Under This Title, Medicaid, or
CHIP.--
``(1) No impact on benefits under this title.--Any payment
made to an entity under this section shall not be treated as
benefits under this title or otherwise taken into account in
computing--
``(A) actuarial rates or premium amounts under section
1839; or
``(B) the MA area-specific non-drug monthly benchmark
amount under section 1853(j).
``(2) Disregard of payments for purposes of medicaid and
chip.--Any payment made to an entity under this section shall
be disregarded when determining income for any purpose under
the programs established under title XIX and title XXI.
``(g) Exception From Reduction or Offset.--Payments under
this section shall not be subject to offset under section
3716 of title 31, United States Code.
``(h) Implementation.--In addition to amounts otherwise
available, there is appropriated to the Secretary for fiscal
year 2022, out of amounts in the Treasury not otherwise
appropriated, $193,000,000, to remain available until
December 31, 2025, to carry out this section (other than
subsection (e) and subsection (i)).
``(i) Funding for Payments.--In addition to amounts
otherwise available, there is appropriated to the Secretary
for fiscal year 2022, out of amounts in the Treasury not
otherwise appropriated, $58,000,000,000, to remain available
until December 31, 2024, for purposes of funding payments for
eligible expenses under the program through Treasury-
sponsored accounts described in subsection (c)(2)(A)(i) which
shall supplement and not supplant any other appropriations
that may be available for this purpose.''.

SEC. 11502. COVERAGE OF DENTAL AND ORAL HEALTH CARE.

(a) Coverage.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (GG), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (HH), by striking the period at the end
and adding ``; and''; and
(3) by adding at the end the following new subparagraph:
``(II) dental and oral health services (as defined in
subsection (lll));''.
(b) Dental and Oral Health Services Defined.--Section 1861
of the Social Security Act (42 U.S.C. 1395x) is amended by
adding at the end the following new subsection:
``(lll) Dental and Oral Health Services.--
``(1) In general.--Except as provided in paragraph (2), the
term `dental and oral health services' means the following
items and services that are furnished by a doctor of dental
surgery or of dental medicine (as described in subsection
(r)(2)) or an oral health professional (as defined in
paragraph (3)) on or after January 1, 2025:
``(A) Preventive and screening services.--Preventive and
screening services, including oral exams, dental cleanings,
dental x-rays, and fluoride treatments.
``(B) Basic procedures.--Basic procedures, including
services such as minor restorative services, periodontal
maintenance, periodontal scaling and root planing, simple

[[Page S4239]]

tooth extractions, therapeutic pulpotomy, and other related
items and services.
``(C) Dentures.--Dentures and implants including related
items and services.
``(2) Exclusions.--Such term does not include items and
services for which, as of the date of the enactment of this
subsection, coverage was permissible under section
1862(a)(12) and cosmetic services not otherwise covered under
section 1862(a)(10).
``(3) Oral health professional.--The term `oral health
professional' means, with respect to dental and oral health
services, a health professional (other than a doctor of
dental surgery or of dental medicine (as described in
subsection (r)(2))) who is licensed to furnish such services,
acting within the scope of such license, by the State in
which such services are furnished.''.
(c) Payment; Coinsurance; and Limitations.--
(1) In general.--Section 1833(a)(1) of the Social Security
Act (42 U.S.C. 1395l(a)(1)), as amended by section 11101, is
amended--
(A) in subparagraph (N), by inserting ``and dental and oral
health services (as defined in section 1861(lll))'' after
``section 1861(hhh)(1))'';
(B) by striking ``and'' before ``(EE)''; and
(C) by inserting before the semicolon at the end the
following: ``and (FF) with respect to dental and oral health
services (as defined in section 1861(lll)), the amount paid
shall be the payment amount specified under section
1834(z)''.
(2) Payment and limits specified.--Section 1834 of the
Social Security Act (42 U.S.C. 1395m) is amended by adding at
the end the following new subsection:
``(z) Payment and Limits for Dental and Oral Health
Services.--
``(1) Payment.--The payment amount under this part for
dental and oral health services (as defined in section
1861(lll)) shall be, subject to paragraphs (3) and (4), 80
percent of the lesser of--
``(A) the actual charge for the service; or
``(B)(i) in the case of such services furnished by a doctor
of dental surgery or of dental medicine (as described in
section 1861(r)(2)), the amount determined under the fee
schedule established under paragraph (2); or
``(ii) in the case of such services furnished by an oral
health professional (as defined in section 1861(lll)(3)), 85
percent of the amount determined under the fee schedule
established under paragraph (2).
``(2) Establishment of fee schedule for dental and oral
health services.--
``(A) Establishment.--
``(i) In general.--The Secretary shall establish a fee
schedule for dental and oral health services furnished in
2025 and subsequent years. The fee schedule amount for a
dental or oral health service shall be equal 70 percent of
the national median fee (as determined under subparagraph
(B)) for the service or a similar service for the year (or,
in the case of dentures, at the bundled payment amount under
clause (iv) of such subparagraph), adjusted by the geographic
adjustment factor established under section 1848(e)(2) for
the area for the year.
``(ii) Consultation.--In carrying out this paragraph, the
Secretary shall consult annually with organizations
representing dentists and other providers who furnish dental
and oral health services and shall share with such providers
the data and data analysis used to determine fee schedule
amounts under this paragraph.
``(B) Determination of national median fee.--
``(i) In general.--For purposes of subparagraph (A), the
Secretary shall apply the national median fee for a dental or
oral health service for 2025 and subsequent years in
accordance with this subparagraph.
``(ii) Use of 2020 dental fee survey.--

``(I) In general.--Except as provided in clause (iii) or
clause (iv), the national median fee for a dental or oral
health service shall be equal to--

``(aa) for 2025, the median fee for the service in the
table titled `General Practitioners-National' of the `2020
Survey of Dental Fees' published by the American Dental
Association, increased by the applicable percent increase for
the year determined under subclause (II), as reduced by the
productivity adjustment under subclause (III); and
``(bb) for 2026 and subsequent years, the amount determined
under this subclause for the preceding year, updated pursuant
to subparagraph (C)(i).

``(II) Applicable percent increase.--The applicable percent
increase determined under this subclause for a year is an
amount equal to the percentage increase between--

``(aa) the consumer price index for all urban consumers
(United States city average) ending with June of the previous
year; and
``(bb) the consumer price index for all urban consumers
(United States city average) ending with June of 2020.

``(III) Productivity adjustment.--After determining the
applicable percentage increase under subclause (II) for a
year, the Secretary shall reduce such percentage increase by
the productivity adjustment described in section
1886(b)(3)(B)(xi)(II).

``(iii) Determination if insufficient survey data.--If the
Secretary determines there is insufficient data under the
Survey described in clause (ii) with respect to a dental or
oral health service, the national median fee for the service
for a year shall be equal to an amount established for the
service using one or more of the following methods, as
determined appropriate by the Secretary:

``(I) The payment basis determined under section 1848.
``(II) Fee schedules for dental and oral health services
which shall include, as practicable, fee schedules--

``(aa) under Medicare Advantage plans under part C;
``(bb) under State plans (or waivers of such plans) under
title XIX; and
``(cc) established by other health care payers.
``(iv) Special rule for dentures.--The Secretary shall make
payment for dentures and associated professional services as
a bundled payment as determined by the Secretary. In
establishing such bundled payment, the Secretary shall
consider the national median fee for the service for the year
determined under clause (ii) or (iii) and the rate determined
for such dentures under the Federal Supply Schedule of the
General Services Administration, as published by such
Administration in 2021, updated to the year involved using
the applicable percent increase for the year determined under
clause (ii)(II), as reduced by the productivity adjustment
under clause (ii)(III), and shall ensure that the payment
component for dentures under such bundled payment does not
exceed the maximum rate determined for such dentures under
the Federal Supply Schedule, as so published and updated to
the year involved.
``(C) Annual update and adjustments.--
``(i) Annual update.--The Secretary shall update payment
amounts determined under the fee schedule from year to year
beginning in 2026 by increasing such amounts from the prior
year by the percentage increase in the consumer price index
for all urban consumers (United States city average) for the
12-month period ending with June of the preceding year,
reduced by the productivity adjustment described in section
1886(b)(3)(B)(xi)(II).
``(ii) Adjustments.--

``(I) In general.--The Secretary shall, to the extent the
Secretary determines to be necessary and subject to subclause
(II), adjust the amounts determined under the fee schedule
established under this paragraph for 2026 and subsequent
years to take into account changes in dental practice, coding
changes, new data on work, practice, or malpractice expenses,
or the addition of new procedures.
``(II) Limitation on annual adjustments.--The adjustments
under subclause (I) for a year shall not cause the amount of
expenditures under this part for the year to differ by more
than $20,000,000 from the amount of expenditures under this
part that would have been made if such adjustments had not
been made.

``(3) Limitations.--With respect to dental and oral health
services that are preventive and screening services described
in paragraph (1)(A) of section 1861(lll)--
``(A) payment shall be made under this part for--
``(i) not more than 2 oral exams in a year;
``(ii) not more than 2 dental cleanings in a year;
``(iii) not more than 1 fluoride treatment in a year; and
``(iv) not more than 1 full-mouth series of x-rays as part
of a preventive and screening oral exam every 3 years; and
``(B) in the case of preventive and screening services not
described in subparagraph (A), payment shall be made under
this part only at such frequencies determined appropriate by
the Secretary.
``(4) Incentives for rural providers.--In the case of
dental and oral health services furnished by a doctor of
dental surgery or of dental medicine (as described in section
1861(r)(2)) or an oral health professional (as defined in
section 1861(lll)(3)) who predominantly furnishes such
services under this part in an area that is designated by the
Secretary (under section 332(a)(1)(A) of the Public Health
Service Act) as a health professional shortage area, in
addition to the amount of payment that would otherwise be
made for such services under this subsection, there also
shall be paid an amount equal to 10 percent of the payment
amount for the service under this subsection for such doctor
or professional.
``(5) Limitation on beneficiary liability.--The provisions
of section 1848(g) shall apply to a nonparticipating doctor
of dental surgery or of dental medicine (as described in
subsection (r)(2)) who does not accept payment on an
assignment-related basis for dental and oral health services
furnished with respect to an individual enrolled under this
part in the same manner as such provisions apply with respect
to a physician's service.
``(6) Establishment of dental administrator.--The Secretary
shall designate one or more (not to exceed 4) medicare
administrative contractors under section 1874A to establish
coverage policies and establish such policies and process
claims for payment for dental and oral health services, as
determined appropriate by the Secretary.''.
(d) Inclusion of Oral Health Professionals as Certain
Practitioners.--Section 1842(b)(18)(C) of the Social Security
Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the
end the following new clause:
``(vii) With respect to 2026 and each subsequent year, an
oral health professional (as defined in section
1861(lll)(3)).''.
(e) Exclusion Modifications.--Section 1862(a) of the Social
Security Act (42 U.S.C. 1395y(a)) is amended--
(1) in paragraph (1)--

[[Page S4240]]

(A) in subparagraph (O), by striking ``and'' at the end;
(B) in subparagraph (P), by striking the semicolon at the
end and inserting ``, and''; and
(C) by adding at the end the following new subparagraph:
``(Q) in the case of dental and oral health services (as
defined in section 1861(lll)) for which a limitation is
applicable under section 1834(z)(3), which are furnished more
frequently than is provided under such section.''; and
(2) in paragraph (12), by inserting before the semicolon at
the end the following: ``and except that payment shall be
made under part B for dental and oral health services that
are covered under section 1861(s)(2)(II)''.
(f) Inclusion as Excepted Medical Treatment.--Section
1821(b)(5)(A)(iii) of the Social Security Act (42 U.S.C.
1395i-5(b)(5)(A)), as added by section 11501(d), is amended--
(1) by striking ``or hearing aids'' and inserting ``hearing
aids''; and
(2) by inserting ``, or dental and oral health services (as
defined in subsection (lll) of such section)'' after
``subsection (s)(8) of such section''.
(g) Rural Health Clinics and Federally Qualified Health
Centers.--
(1) Coverage of dental and oral health services.--Section
1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)), is
amended--
(A) in paragraph (1)--
(i) in subparagraph (B), by striking ``and'' at the end;
(ii) in subparagraph (C), by inserting ``and'' after the
comma at the end; and
(iii) by inserting after subparagraph (C) the following new
subparagraph:
``(D) dental and oral health services (as defined in
subsection (lll)) furnished by a doctor of dental surgery or
of dental medicine (as described in subsection (r)(2)) or an
oral health professional (as defined in subsection (lll)(3))
who is employed by or working under contract with a rural
health clinic if such rural health clinic furnishes such
services,''; and
(B) in paragraph (3)(A), by striking ``(C)'' and inserting
``(D)''.
(2) Temporary payment rates for certain services under the
rhc air and fqhc pps.--
(A) AIR.--Section 1833 of the Social Security Act (42
U.S.C. 1395l) is amended--
(i) in subsection (a)(3)(A), by inserting ``(which shall,
in the case of dental and oral health services (as defined in
section 1861(lll)), in lieu of any limits on reasonable costs
otherwise applicable, be based on the rates payable for such
services under the payment basis determined under section
1848 until such time as the Secretary determines sufficient
data has been collected to otherwise apply such limits (or
January 1, 2030, if no such determination has been made as of
such date))'' after ``may prescribe in regulations''; and
(ii) by adding at the end the following new subsection:
``(ee) Disregard of Costs Attributable to Certain Services
From Calculation of RHC AIR.--Payments for rural health
clinic services other than dental and oral health services
(as defined in section 1861(lll)) under the methodology for
all-inclusive rates (established by the Secretary) under
subsection (a)(3) shall not take into account the costs of
such services while rates for such services are based on
rates payable for such services under the payment basis
established under section 1848.''.
(B) PPS.--Section 1834(o) of the Social Security Act (42
U.S.C. 1395m(o)) is amended by adding at the end the
following new paragraph:
``(5) Temporary payment rates based on pfs for certain
services.--The Secretary shall, in establishing payment rates
for dental and oral health services (as defined in section
1861(lll) that are Federally qualified health center services
under the prospective payment system established under this
subsection, in lieu of the rates otherwise applicable under
such system, base such rates on rates payable for such
services under the payment basis established under section
1848 until such time as the Secretary determines sufficient
data has been collected to otherwise establish rates for such
services under such system (or January 1, 2030, if no such
determination has been made as of such date). Payments for
Federally qualified health center services other than such
dental and oral health services under such system shall not
take into account the costs of such services while rates for
such services are based on rates payable for such services
under the payment basis established under section 1848.''.
(h) Implementation.--In addition to amounts otherwise
available, there is appropriated to the Secretary of Health
and Human Services for fiscal year 2022, out of any money in
the Treasury not otherwise appropriated, $900,000,000, to
remain available until expended, for purposes of implementing
the amendments made by this section during the period
beginning on January 1, 2022, and ending on September 30,
2031.

SEC. 11503. PROVIDING COVERAGE FOR HEARING CARE UNDER THE
MEDICARE PROGRAM.

(a) Provision of Audiology Services by Qualified
Audiologists and Hearing Aid Examination Services by
Qualified Hearing Aid Professionals.--
(1) In general.--Section 1861(ll) of the Social Security
Act (42 U.S.C. 1395x(ll)) is amended--
(A) in paragraph (3)--
(i) by inserting ``(A)'' after ``(3)'';
(ii) in subparagraph (A), as added by clause (i) of this
subparagraph--

(I) by striking ``means such hearing and balance assessment
services'' and inserting ``means--

``(i) such hearing and balance assessment services and,
beginning January 1, 2024, such hearing aid examination
services and treatment services (including aural
rehabilitation, vestibular rehabilitation, and cerumen
management)'';

(II) in clause (i), as added by subclause (I) of this
clause, by striking the period at the end and inserting ``;
and''; and
(III) by adding at the end the following new clause:

``(ii) beginning January 1, 2024, such hearing aid
examination services furnished by a qualified hearing aid
professional (as defined in paragraph (4)(C)) as the
professional is legally authorized to perform under State law
(or the State regulatory mechanism provided by State law), as
would otherwise be covered if furnished by a physician.'';
and
(iii) by adding at the end the following new subparagraph:
``(B) Beginning January 1, 2024, audiology services
described in subparagraph (A)(i) shall be furnished without a
requirement for an order from a physician or practitioner.'';
and
(B) in paragraph (4), by adding at the end the following
new subparagraph:
``(C) The term `qualified hearing aid professional' means
an individual who--
``(i) is licensed or registered as a hearing aid dispenser,
hearing aid specialist, hearing instrument dispenser, or
related professional by the State in which the individual
furnishes such services; and
``(ii) is accredited by the National Board for
Certification in Hearing Instrument Sciences or meets such
other requirements as the Secretary determines appropriate
(including requirements relating to educational
certifications or accreditations) taking into account any
additional relevant requirements for hearing aid specialists,
hearing aid dispensers, and hearing instrument dispensers
established by Medicare Advantage organizations under part C,
State plans (or waivers of such plans) under title XIX, and
group health plans and health insurance issuers (as such
terms are defined in section 2791 of the Public Health
Service Act).''.
(2) Payment for qualified hearing aid professionals.--
Section 1833(a)(1) of the Social Security Act (42 U.S.C.
1395l(a)(1)), as amended by section 11101(b) and 11501, is
further amended--
(A) by striking ``and'' before ``(FF)''; and
(B) by inserting before the semicolon at the end the
following: ``and (GG) with respect to hearing aid examination
services (as described in paragraph (3)(A)(ii) of section
1861(ll)) furnished by a qualified hearing aid professional
(as defined in paragraph (4)(C) of such section), the amounts
paid shall be equal to 80 percent of the lesser of the actual
charge for such services or 85 percent of the amount for such
services determined under the payment basis determined under
section 1848''.
(3) Inclusion of qualified audiologists and qualified
hearing aid professionals as certain practitioners to receive
payment on an assignment-related basis.--
(A) Qualified audiologists.--Section 1842(b)(18)(C) of the
Social Security Act (42 U.S.C. 1395u(b)(18)(C)), as amended
by section 11502, is amended by adding at the end the
following new clause:
``(viii) Beginning on January 1, 2024, a qualified
audiologist (as defined in section 1861(ll)(4)(B)).''.
(B) Qualified hearing aid professionals.--Section
1842(b)(18) of the Social Security Act (42 U.S.C.
1395u(b)(18)) is amended--
(i) in each of subparagraphs (A) and (B), by ``striking
subparagraph (C)'' and inserting ``subparagraph (C) or,
beginning on January 1, 2024, subparagraph (E)''; and
(ii) by adding at the end the following new subparagraph:
``(E) A practitioner described in this subparagraph is a
qualified hearing aid professional (as defined in section
1861(ll)(4)(C)).''.
(b) Coverage of Hearing Aids.--
(1) Inclusion of hearing aids as prosthetic devices.--
Section 1861(s)(8) of the Social Security Act (42 U.S.C.
1395x(s)(8)) is amended by inserting ``, and including
hearing aids (as described in section 1834(h)(7)) furnished
on or after January 1, 2024, to individuals with moderately
severe, severe, or profound hearing loss'' before the
semicolon at the end.
(2) Payment limitations for hearing aids.--Section 1834(h)
of the Social Security Act (42 U.S.C. 1395m(h)) is amended by
adding at the end the following new paragraphs:
``(6) Payment only on an assignment-related basis.--Payment
for hearing aids for which payment may be made under this
part may be made only on an assignment-related basis. The
provisions of subparagraphs (A) and (B) of section
1842(b)(18) shall apply to hearing aids in the same manner as
they apply to services furnished by a practitioner described
in subparagraph (C) of such section.
``(7) Limitations for hearing aids.--
``(A) In general.--Payment may be made under this part with
respect to an individual, with respect to hearing aids
furnished by a qualified hearing aid supplier (as defined in
subparagraph (B)) on or after January 1, 2024--

[[Page S4241]]

``(i) not more than once per ear during a 5-year period;
``(ii) only for types of such hearing aids that are
determined appropriate by the Secretary; and
``(iii) only if furnished pursuant to a written order of a
physician, qualified audiologist (as defined in section
1861(ll)(4)), qualified hearing aid professional (as so
defined), physician assistant, nurse practitioner, or
clinical nurse specialist.
``(B) Definitions.--In this subsection:
``(i) Hearing aid.--The term `hearing aid' means the item
and related services including selection, fitting,
adjustment, and patient education and training.
``(ii) Qualified hearing aid supplier.--The term `qualified
hearing aid supplier' means--

``(I) a qualified audiologist;
``(II) a physician (as defined in section 1861(r)(1));
``(III) a physician assistant, nurse practitioner, or
clinical nurse specialist;
``(IV) a qualified hearing aid professional (as defined in
1861(ll)(4)(C)); and
``(V) other suppliers as determined by the Secretary.''.

(3) Application of competitive acquisition.--
(A) In general.--Section 1834(h)(1)(H) of the Social
Security Act (42 U.S.C. 1395m(h)(1)(H)) is amended--
(i) in the header, by inserting ``and hearing aids'' after
``orthotics'';
(ii) by inserting ``or of hearing aids described in
paragraph (2)(D) of such section,'' after ``2011,''; and
(iii) in clause (i), by inserting ``or such hearing aids''
after ``such orthotics''.
(B) Conforming amendments.--
(i) In general.--Section 1847(a)(2) of the Social Security
Act (42 U.S.C. 1395w-3(a)(2)) is amended by adding at the end
the following new subparagraph:
``(D) Hearing aids.--Hearing aids described in section
1861(s)(8) for which payment would otherwise be made under
section 1834(h).''.
(ii) Exemption of certain items from competitive
acquisition.--Section 1847(a)(7) of the Social Security Act
(42 U.S.C. 1395w-3(a)(7)) is amended by adding at the end the
following new subparagraph:
``(C) Certain hearing aids.--Those items and services
described in paragraph (2)(D) if furnished by a physician or
other practitioner (as defined by the Secretary) to the
physician's or practitioner's own patients as part of the
physician's or practitioner's professional service.''.
(iii) Implementation.--Section 1847(a) of the Social
Security Act (42 U.S.C. 1395w-3(a)) is amended by adding at
the end the following new paragraph:
``(8) Competition with respect to hearing aids.--Not later
than January 1, 2029, the Secretary shall begin the
competition with respect to the items and services described
in paragraph (2)(D).''.
(4) Physician self-referral law.--Section 1877(b) of the
Social Security Act (42 U.S.C. 1395nn(b)) is amended by
adding at the end the following new paragraph:
``(6) Hearing aids and services.--In the case of hearing
aid examination services and hearing aids--
``(A) furnished on or after January 1, 2024, and before
January 1, 2026; and
``(B) furnished on or after January 1, 2026, if the
financial relationship specified in subsection (a)(2) meets
such requirements the Secretary imposes by regulation to
protect against program or patient abuse.''.
(c) Exclusion Modification.--Section 1862(a)(7) of the
Social Security Act (42 U.S.C. 1395y(a)(7)) is amended by
inserting ``(except such hearing aids or examinations
therefor as described in and otherwise allowed under section
1861(s)(8))'' after ``hearing aids or examinations
therefor''.
(d) Inclusion as Excepted Medical Treatment.--Section
1821(b)(5)(A) of the Social Security Act (42 U.S.C. 1395i-
5(b)(5)(A)) is amended--
(1) in clause (i), by striking ``or'';
(2) in clause (ii), by striking the period and inserting
``, or''; and
(3) by adding at the end the following new clause:
``(iii) consisting of audiology services described in
subsection (ll)(3) of section 1861, or hearing aids described
in subsection (s)(8) of such section, that are payable under
part B as a result of the amendments made by the Act titled
`An Act to provide for reconciliation pursuant to title II of
S. Con. Res. 14'.''.
(e) Rural Health Clinics and Federally Qualified Health
Centers.--
(1) Clarifying coverage of audiology services as
physicians' services.--Section 1861(aa)(1)(A) of the Social
Security Act (42 U.S.C. 1395x(aa)(1)(A)) is amended by
inserting ``(including audiology services (as defined in
subsection (ll)(3)))'' after ``physicians' services''.
(2) Inclusion of qualified audiologists and qualified
hearing aid professionals as rhc and fqhc practitioners.--
Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C.
1395x(aa)(1)(B)) is amended by inserting ``or by a qualified
audiologist or a qualified hearing aid professional (as such
terms are defined in subsection (ll)),'' after ``(as defined
in subsection (hh)(1)),''.
(3) Temporary payment rates for certain services under the
rhc air and fqhc pps.--
(A) AIR.--Section 1833 of the Social Security Act (42
U.S.C. 1395l), as amended by section 11502(g), is amended--
(i) in subsection (a)(3)(A), by inserting ``and audiology
services (as defined in section 1861(ll)(3))'' after ``(as
defined in section 1861(lll)''; and
(ii) in subsection (e), by inserting ``and audiology
services (as defined in section 1861(ll)(3))'' after ``(as
defined in section 1861(lll)''.
(B) PPS.--Section 1834(o)(5) of the Social Security Act (42
U.S.C. 1395m(o)), as added by section 11501(e), is amended--
(i) in the first sentence, by inserting `` and audiology
services (as defined in section 1861(ll)(3))'' after ``(as
defined in section 1861(lll))''; and
(ii) in the second sentence, by inserting ``and such
audiology services'' after ``such dental and oral health
services''.
(f) Implementation for 2023 Through 2025.--The Secretary of
Health and Human Services shall implement the provisions of,
and the amendments made by, this section for 2023, 2024, and
2025 by program instruction or other forms of program
guidance.
(g) Funding.--In addition to amounts otherwise available,
there is appropriated to the Secretary of Health and Human
Services for fiscal year 2022, out of any money in the
Treasury not otherwise appropriated, $370,000,000, to remain
available until expended, for purposes of implementing the
amendments made by this section during the period beginning
on January 1, 2023, and ending on September 30, 2032.

SEC. 11504. PROVIDING COVERAGE FOR VISION CARE UNDER THE
MEDICARE PROGRAM.

(a) Coverage.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)), as amended by section 11502(a),
is amended--
(1) in subparagraph (HH), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (II), by striking the period at the end
and adding ``; and''; and
(3) by adding at the end the following new subparagraph:
``(JJ) vision services (as defined in subsection (mmm));''.
(b) Vision Services Defined.--Section 1861 of the Social
Security Act (42 U.S.C. 1395x), as amended by section
11502(b), is amended by adding at the end the following new
subsection:
``(mmm) Vision Services.--The term `vision services' means
routine eye examinations to determine the refractive state of
the eyes, including procedures performed during the course of
such examination, furnished on or after January 1, 2023, by
or under the direct supervision of an ophthalmologist or
optometrist who is legally authorized to furnish such
examinations or procedures (as applicable) under State law
(or the State regulatory mechanism provided by State law) of
the State in which the examinations or procedures are
furnished.''.
(c) Payment Limitations.--Section 1834 of the Social
Security Act (42 U.S.C. 1395m), as amended by section
11502(c), is amended by adding at the end the following new
subsection:
``(aa) Limitation for Vision Services.--With respect to
vision services (as defined in section 1861(mmm)) and an
individual, payment shall be made under this part for only 1
routine eye examination described in such subsection during a
2-year period.''.
(d) Payment Under Physician Fee Schedule.--Section
1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-
4(j)(3)) is amended by inserting ``(2)(JJ),'' before ``(3)''.
(e) Coverage of Conventional Eyeglasses.--Section
1861(s)(8) of the Social Security Act (42 U.S.C.
1395x(s)(8)), as amended by section 11503(b), is amended by
striking ``, and including one pair of conventional
eyeglasses or contact lenses furnished subsequent to each
cataract surgery with insertion of an intraocular lens'' and
inserting ``, including one pair of conventional eyeglasses
or contact lenses furnished subsequent to each cataract
surgery with insertion of an intraocular lens, if furnished
before January 1, 2023, and including (as described in
section 1834(h)(8)) conventional eyeglasses, whether or not
furnished subsequent to such a surgery, if furnished on or
after January 1, 2023''.
(f) Special Payment Rules for Eyeglasses.--
(1) Limitations.--Section 1834(h) of the Social Security
Act (42 U.S.C. 1395m(h)), as amended by section 11503(b), is
amended by adding at the end the following new paragraph:
``(8) Payment limitations for eyeglasses.--
``(A) In general.--With respect to conventional eyeglasses
furnished to an individual on or after January 1, 2023,
subject to subparagraph (B), payment shall be made under this
part only during a 2-year period, for one pair of eyeglasses
(including lenses and the frame).
``(B) Exception.--With respect to a 2-year period described
in subparagraph (A), in the case of an individual who
receives cataract surgery with insertion of an intraocular
lens, payment shall be made under this part for one pair of
conventional eyeglasses furnished subsequent to such cataract
surgery during such period.
``(C) No coverage of certain items.--Payment shall not be
made under this part for deluxe eyeglasses or conventional
reading glasses.''.
(2) Application of competitive acquisition.--
(A) In general.--Section 1834(h)(1)(H) of the Social
Security Act (42 U.S.C. 1395m(h)(1)(H)), as amended by
section 11503(b), is amended--
(i) in the header, by striking ``and hearing aids'' and
inserting ``hearing aids, and eyeglasses''

[[Page S4242]]

(ii) by striking ``or of hearing aids'' and inserting ``of
hearing aids'';
(iii) by inserting ``or of eyeglasses described in
paragraph (2)(E) of such section,'' after ``paragraph (2)(D)
of such section,''; and
(iv) in clause (i), by striking ``or such hearing aids''
and inserting ``, such hearing aids, or such eyeglasses''.
(B) Conforming amendment.--Section 1847(a)(2) of the Social
Security Act (42 U.S.C. 1395w-3(a)(2)), as amended by section
11503(b), is amended by adding at the end the following new
subparagraph:
``(E) Eyeglasses.--Eyeglasses described in section
1861(s)(8) for which payment would otherwise be made under
section 1834(h).''.
(C) Implementation.--Section 1847(a) of the Social Security
Act (42 U.S.C. 1395w-3(a)), as amended by section 11503(b),
is amended by adding at the end the following new paragraph:
``(9) Competition with respect to eyeglasses.--Not later
than January 1, 2028, the Secretary shall begin the
competition with respect to the items and services described
in paragraph (2)(E).''.
(g) Exclusion Modifications.--Section 1862(a) of the Social
Security Act (42 U.S.C. 1395y(a)), as amended by section
11502(e), is amended--
(1) in paragraph (1)--
(A) in subparagraph (P), by striking ``and'' at the end;
(B) in subparagraph (Q), by striking the semicolon at the
end and inserting ``, and''; and
(C) by adding at the end the following new subparagraph:
``(R) in the case of vision services (as defined in section
1861(mmm)) that are routine eye examinations as described in
such section, which are furnished more frequently than once
during a 2-year period;''; and
(2) in paragraph (7)--
(A) by inserting ``(other than such an examination that is
a vision service that is covered under section
1861(s)(2)(JJ))'' after ``eye examinations''; and
(B) by inserting ``(other than such a procedure that is a
vision service that is covered under section
1861(s)(2)(JJ))'' after ``refractive state of the eyes''.
(h) Inclusion as Excepted Medical Treatment.--Section
1821(b)(5)(A)(iii) of the Social Security Act (42 U.S.C.
1395i-5(b)(5)(A)), as added by section 11501(d) and amended
by section 11503(f), is amended--
(1) by striking ``or dental'' and inserting ``dental''; and
(2) by inserting ``, or vision services (as defined in
subsection (mmm) of such section)'' after ``(as defined in
subsection (lll) of such section)''.
(i) Rural Health Clinics and Federally Qualified Health
Centers.--
(1) Clarifying coverage of vision services as physicians'
services.--Section 1861(aa)(1)(A) of the Social Security Act
(42 U.S.C. 1395x(aa)(1)(A)), as amended by section 11501(e),
is amended by inserting ``and vision services (as defined in
subsection (mmm))'' after ``(as defined in subsection
(ll)(3))''.
(2) Temporary payment rates for certain services under the
rhc air and fqhc pps.--
(A) AIR.--Section 1833 of the Social Security Act (42
U.S.C. 1395l), as amended by sections 11502(g) and 11503(e),
is amended--
(i) in subsection (a)(3)(A)--

(I) by striking ``or audiology'' and inserting ``,
audiology''; and
(II) by inserting ``, or vision services (as defined in
section 1861(mmm))'' after ``(as defined in section
1861(ll)(3))''; and

(ii) in subsection (e)--

(I) by striking ``or audiology'' and inserting ``,
audiology''; and
(II) by inserting ``, and vision services (as defined in
section 1861(mmm))'' after ``(as defined in section
1861(ll)(3))''.

(B) PPS.--Section 1834(o)(5) of the Social Security Act (42
U.S.C. 1395m(o)), as added by section 11502(g) and amended by
section 11503(e), is amended--
(i) in the first sentence--

(I) by striking ``and audiology'' and inserting ``,
audiology''; and
(II) by inserting ``, and vision services (as defined in
section 1861(mmm))'' after ``(as defined in section
1861(ll)(3))''; and

(ii) in the second sentence, by striking ``and such
audiology services'' and inserting ``, such audiology
services, and such vision services''.
(j) Expediting Implementation.--The Secretary shall
implement this section for the period beginning on January 1,
2023, and ending on December 31, 2024, through program
instruction or other forms of program guidance.
(k) Funding.--In addition to amounts otherwise available,
there is appropriated to the Secretary of Health and Human
Services for fiscal year 2022, out of any money in the
Treasury not otherwise appropriated, $500,000,000, to remain
available until expended, for purposes of implementing the
amendments made by this section during the period beginning
on January 1, 2023, and ending on September 30, 2031.

SEC. 11505. PHASE-IN OF IMPACT OF DENTAL AND ORAL HEALTH
COVERAGE ON PART B PREMIUMS.

Section 1839(a) of the Social Security Act (42 U.S.C.
1395r(a)) is amended--
(1) in the second sentence of paragraph (1), by striking
``and (7)'' and inserting ``(7), and (8)'';
(2) in paragraph (3), by striking ``The Secretary'' and
inserting ``Subject to paragraph (8)(C), the Secretary''; and
(3) by adding at the end the following:
``(8) Special Rule for 2025 Through 2028.--
``(A) Determination of alternative monthly actuarial rate
for each of 2025 through 2028.--For each of 2025 through
2028, the Secretary shall, at the same time as and in
addition to the determination of the monthly actuarial rate
for enrollees age 65 and over determined in each of 2024
through 2027 for the succeeding calendar year according to
paragraph (1), determine an alternative monthly actuarial
rate for enrollees age 65 and over for the year as described
in subparagraph (B).
``(B) Alternative monthly actuarial rate described.--
``(i) In general.--The alternative monthly actuarial rate
described in this subparagraph is--
``(I) for 2025, the monthly actuarial rate for enrollees
age 65 and over for the year, determined as if the amendments
made by section 11502 of the Act titled `An Act to provide
for reconciliation pursuant to title II of S. Con. Res. 14'
did not apply; and
``(II) for 2026, 2027, and 2028, the monthly actuarial rate
for enrollees age 65 and over for the year, determined as if
the amendments made by such section 11502 did not apply, plus
the applicable percent of the amount by which--

``(aa) the monthly actuarial rate for enrollees age 65 and
over for the year determined according to paragraph (1);
exceeds
``(bb) the monthly actuarial rate for enrollees age 65 and
over for the year, determined as if the amendments made by
such section 11502 did not apply.

``(ii) Definition of applicable percent.--For purposes of
this subparagraph, the term `applicable percent' means--
``(I) for 2026, 25 percent;
``(II) for 2027, 50 percent; and
``(III) for 2028, 75 percent.
``(C) Application to part b premium and other provisions of
this part.--For each of 2025 through 2028, the Secretary
shall use the alternative monthly actuarial rate for
enrollees age 65 and over for the year determined under
subparagraph (A), in lieu of the monthly actuarial rate for
such enrollees for the year determined according to paragraph
(1), when determining the monthly premium rate for the year
under paragraph (3) and subsection (j), the part B deductible
under section 1833(b), and the premium subsidy and monthly
adjustment amount under subsection (i).''.

Subpart B--Tax Provisions

SEC. 11511. APPLICATION OF NET INVESTMENT INCOME TAX TO TRADE
OR BUSINESS INCOME OF CERTAIN HIGH INCOME
INDIVIDUALS.

(a) In General.--Section 1411 of the Internal Revenue Code
of 1986 is amended by adding at the end the following new
subsection:
``(f) Application to Certain High Income Individuals.--
``(1) In general.--In the case of any individual whose
modified adjusted gross income for the taxable year exceeds
the high income threshold amount, subsection (a)(1) shall be
applied by substituting `the greater of specified net income
or net investment income' for `net investment income' in
subparagraph (A) thereof.
``(2) Phase-in of increase.--The increase in the tax
imposed under subsection (a)(1) by reason of the application
of paragraph (1) of this subsection shall not exceed the
amount which bears the same ratio to the amount of such
increase (determined without regard to this paragraph) as--
``(A) the excess described in paragraph (1), bears to
``(B) $100,000 (\1/2\ such amount in the case of a married
taxpayer (as defined in section 7703) filing a separate
return).
``(3) High income threshold amount.--For purposes of this
subsection, the term `high income threshold amount' means--
``(A) except as provided in subparagraph (B) or (C),
$400,000,
``(B) in the case of a taxpayer making a joint return under
section 6013 or a surviving spouse (as defined in section
2(a)), $500,000, and
``(C) in the case of a married taxpayer (as defined in
section 7703) filing a separate return, \1/2\ of the dollar
amount determined under subparagraph (B).
``(4) Specified net income.--For purposes of this section,
the term `specified net income' means net investment income
determined--
``(A) without regard to the phrase `other than such income
which is derived in the ordinary course of a trade or
business not described in paragraph (2),' in subsection
(c)(1)(A)(i),
``(B) without regard to the phrase `described in paragraph
(2)' in subsection (c)(1)(A)(ii),
``(C) without regard to the phrase `other than property
held in a trade or business not described in paragraph (2)'
in subsection (c)(1)(A)(iii),
``(D) without regard to paragraphs (2), (3), and (4) of
subsection (c), and
``(E) by treating paragraphs (5) and (6) of section 469(c)
(determined without regard to the phrase `To the extent
provided in regulations,' in such paragraph (6)) as applying
for purposes of subsection (c) of this section.''.
(b) Application to Trusts and Estates.--Section
1411(a)(2)(A) of the Internal Revenue Code of 1986 is amended
by striking ``undistributed net investment income'' and
inserting ``the greater of undistributed specified net income
or undistributed net investment income''.

[[Page S4243]]

(c) Clarifications With Respect to Determination of Net
Investment Income.--
(1) Certain exceptions.--Section 1411(c)(6) of the Internal
Revenue Code of 1986 is amended to read as follows:
``(6) Special rules.--Net investment income shall not
include--
``(A) any item taken into account in determining self-
employment income for such taxable year on which a tax is
imposed by section 1401(b),
``(B) wages received with respect to employment on which a
tax is imposed under section 3101(b) or 3201(a) (including
amounts taken into account under section 3121(v)(2)), and
``(C) wages received from the performance of services
earned outside the United States for a foreign employer.''.
(2) Net operating losses not taken into account.--Section
1411(c)(1)(B) of such Code is amended by inserting ``(other
than section 172)'' after ``this subtitle''.
(3) Inclusion of certain foreign income.--
(A) In general.--Section 1411(c)(1)(A) of such Code is
amended by striking ``and'' at the end of clause (ii), by
striking ``over'' at the end of clause (iii) and inserting
``and'', and by adding at the end the following new clause:
``(iv) any amount includible in gross income under section
951, 951A, 1293, or 1296, over''.
(B) Proper treatment of certain previously taxed income.--
Section 1411(c) of such Code is amended by adding at the end
the following new paragraph:
``(7) Certain previously taxed income.--The Secretary shall
issue regulations or other guidance providing for the
treatment of--
``(A) distributions of amounts previously included in gross
income for purposes of chapter 1 but not previously subject
to tax under this section, and
``(B) distributions described in section 962(d).''.
(d) Deposit Into Medicare Hospital Insurance Trust Fund.--
Section 1817(a) of the Social Security Act (42 U.S.C.
1395i(a)) is amended--
(1) in paragraph (1), by striking ``and'' at the end;
(2) in paragraph (2), by striking the period at the end and
inserting ``; and''; and
(3) by inserting after paragraph (2) the following new
paragraph:
``(3) the excess of--
``(A) the taxes imposed by 1411(a) of the Internal Revenue
Code of 1986, as reported to the Secretary of the Treasury or
his delegate pursuant to subtitle F of such Code after
December 31, 2022, over
``(B) the taxes which would have been imposed under such
section after such date, determined as if the amendments made
by section 11511 of the Act titled `An Act to provide for
reconciliation pursuant to title II of S. Con. Res. 14') did
not apply, as estimated by the Secretary of the Treasury.''.
(e) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2022.
(f) Transition Rule.--The regulations or other guidance
issued by the Secretary under section 1411(c)(7) of the
Internal Revenue Code of 1986 (as added by this section)
shall include provisions which provide for the proper
coordination and application of clauses (i) and (iv) of
section 1411(c)(1)(A) with respect to--
(1) taxable years beginning on or before December 31, 2022,
and
(2) taxable years beginning after such date.

SEC. 11512. INCREASE IN TOP MARGINAL INDIVIDUAL INCOME TAX
RATE.

(a) Re-establishment of 39.6 Percent Rate Bracket.--
(1) Married individuals filing joint returns and surviving
spouses.--The table contained in section 1(j)(2)(A) of the
Internal Revenue Code of 1986 is amended by striking the last
two rows and inserting the following: ``

$91,379, plus 35% of the excess over $400,000..........................
$108,879, plus 39.6% of the excess over $450,000.''....................
(2) Heads of households.--The table contained in section
1(j)(2)(B) of such Code is amended by striking the last two
rows and inserting the following: ``

$44,298, plus 35% of the excess over $200,000..........................
$123,048, plus 39.6% of the excess over $425,000.''....................
(3) Unmarried individuals other than surviving spouses and
heads of households.--The table contained in section
1(j)(2)(C) of such Code is amended by striking the last two
rows and inserting the following: ``

$45,689.50, plus 35% of the excess over $200,000.......................
$115,689.50, plus 39.6% of the excess over $400,000.''.................
(4) Married individuals filing separate returns.--The table
contained in section 1(j)(2)(D) of such Code is amended by
striking the last two rows and inserting the following: ``

$45,689.50, plus 35% of the excess over $200,000.......................
$54,439.50, plus 39.6% of the excess over $225,000.''..................
(5) Estates and trusts.--The table contained in section
1(j)(2)(E) of such Code is amended by striking the last row
and inserting the following: ``

$3,011.50, plus 39.6% of the excess over $12,500.''....................
(b) Application of Adjustments.--Section 1(j)(3) of the
Internal Revenue Code of 1986 is amended to read as follows:
``(3) Adjustments.--For taxable years beginning after
December 31, 2022, the Secretary shall prescribe tables which
shall apply in lieu of the tables contained in paragraph (2)
in the same manner as under paragraphs (1) and (2) of
subsection (f) (applied without regard to clauses (i) and
(ii) of subsection (f)(2)(A)), except that in prescribing
such tables--
``(A) except as provided in subparagraph (B), subsection
(f)(3) shall be applied by substituting `calendar year 2017'
for `calendar year 2016' in subparagraph (A)(ii) thereof,
``(B) in the case of adjustments to the dollar amounts at
which the 39.6 percent rate bracket begins (other than such
dollar amount in paragraph (2)(E))--
``(i) no adjustment shall be made for taxable years
beginning after December 31, 2022, and before January 1,
2024, and
``(ii) in the case of any taxable year beginning after
December 31, 2023, subsection (f)(3) shall be applied by
substituting `calendar year 2022' for `calendar year 2016',
``(C) subsection (f)(7)(B) shall apply to any unmarried
individual other than a surviving spouse, and
``(D) subsection (f)(8) shall not apply.''.
(c) Modification to 39.6 Percent Rate Bracket for High-
income Taxpayers After 2025.--Section 1(i)(3) of the Internal
Revenue Code of 1986 is amended to read as follows:
``(3) Modifications to 39.6 percent rate bracket.--In the
case of taxable years beginning after December 31, 2025--
``(A) In general.--The rate of tax under subsections (a),
(b), (c), and (d) on a taxpayer's taxable income in excess of
the 39.6 percent rate bracket threshold shall be taxed at a
rate of 39.6 percent.
``(B) 39.6 percent rate bracket threshold.--For purposes of
this paragraph, the term `39.6 percent rate bracket
threshold' means--
``(i) in the case any taxpayer described in subsection (a),
$450,000,
``(ii) in the case of any taxpayer described in subsection
(b), $425,000,
``(iii) in the case of any taxpayer described in subsection
(c), $400,000, and
``(iv) in the case of any taxpayer described in subsection
(d), $225,000.
``(C) Inflation adjustment.--For purposes of this
paragraph, with respect to taxable years beginning in
calendar years after 2025, each of the dollar amounts in
subparagraph (B) shall be adjusted in the same manner as
under paragraph (1)(C)(i), except that subsection
(f)(3)(A)(ii) shall be applied by substituting `2022' for
`2016'.''.
(d) Conforming Amendments.--
(1) Section 1(j)(1) of the Internal Revenue Code of 1986 is
amended by striking ``December 31, 2017'' and inserting
``December 31, 2022''.
(2) The heading of section 1(j) is amended by striking
``2018'' and inserting ``2023''.
(3) The heading of section 1(i) is amended by striking
``Rate Reductions'' and inserting ``Modifications''
(4) Section 15(f) is amended by striking ``rate
reductions'' and inserting ``modifications''.
(e) Section 15 Not to Apply.--For rules providing that
section 15 of the Internal Revenue Code of 1986 does not
apply to the amendments made by this section, see sections
1(j)(6) and 15(f) of the Internal Revenue Code of 1986.
(f) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2022.
______