The bill amends section 1804 of the Social Security Act to require the Secretary of HHS (acting through CMS) to conduct outreach and education so Medicare beneficiaries and applicants know they can authorize a family caregiver to access their personal health information via the toll‑free 1‑800‑MEDICARE line by submitting the CMS–10106 caregiver authorization form. The statute directs CMS to make the form and related materials prominent on enrollment notices, Medicare.gov, and Medicare Advantage outreach, to provide materials in other languages, and to train 1‑800‑MEDICARE operators to assist caregivers.
Beyond outreach, the law requires the HHS Office of Inspector General to publish best practices within one year to reduce fraud risks tied to caregiver access, and it mandates beneficiary feedback opportunities (for example, surveys). The measure is implementation-focused: it creates notification, training, and coordination duties for CMS and asks for fraud‑prevention guidance rather than changing HIPAA or substantive privacy rules — but it raises operational and oversight questions for CMS, call centers, and investigators.
At a Glance
What It Does
Adds a new subsection to 42 U.S.C. 1395b–2 requiring CMS to inform Medicare beneficiaries and applicants that they can authorize family caregivers to access their Medicare-related personal health information via 1‑800‑MEDICARE by using the CMS–10106 form, and to train call operators and publish fraud‑prevention best practices.
Who It Affects
CMS and the HHS Office of Inspector General (implementation and guidance), Medicare beneficiaries and authorized family caregivers (access to information), 1‑800‑MEDICARE call centers (operator training and workflows), Medicare Advantage outreach programs and State Health Insurance Assistance Programs (coordination and inclusion).
Why It Matters
It creates a standardized, CMS‑managed pathway (the CMS–10106 form and 1‑800‑MEDICARE channel) for caregivers to obtain beneficiary information and requires OIG‑issued safeguards — a practical change for operations, call centers, and fraud investigators, and a potential lever to improve caregiver support while exposing agencies to new workload and privacy trade‑offs.
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What This Bill Actually Does
The bill inserts a new subsection into the Medicare outreach statute requiring the Secretary to run outreach and education so beneficiaries and applicants learn they can authorize a family caregiver to access their Medicare-related personal health information through the 1‑800‑MEDICARE phone line. The authorization mechanism is the existing CMS–10106 form (or any successor), which CMS must make easy to find and understand on enrollment notices, on Medicare.gov, and in channels used to reach Medicare Advantage enrollees.
CMS must also ensure the authorization form and explanations are available in non‑English languages and coordinate outreach with State Health Insurance Assistance Programs and the Administration for Community Living where practicable. The law specifically directs training for 1‑800‑MEDICARE operators so they can give appropriate resources and procedural assistance to authorized caregivers who call.Separately, within one year the HHS Office of Inspector General must publish best practices to guard beneficiaries against fraud stemming from improper caregiver access; CMS must include those best practices in its outreach.
The statute also requires CMS to solicit caregiver feedback (for example, by surveys) on the experience of using 1‑800‑MEDICARE and the outreach materials. The bill sticks to outreach, training, and guidance; it does not itself amend privacy rules or create a new entitlement, but it establishes a federal, standardized pathway for caregiver access that agencies must operationalize.
The Five Things You Need to Know
The statute requires CMS to include the CMS–10106 caregiver authorization form prominently in the notice under section 1804(a), on Medicare.gov, and in Medicare Advantage outreach materials.
The HHS Office of Inspector General must publish fraud‑prevention best practices and recommendations for timelier investigation of beneficiary fraud reports within one year of enactment.
CMS must train 1‑800‑MEDICARE operators to support family caregivers and provide appropriate resources when callers seek access to beneficiary information.
All outreach materials and the caregiver authorization form must be made available in non‑English languages as specified by the Secretary.
CMS must provide opportunities (for example, surveys) for family caregivers to give feedback about their experiences accessing information via 1‑800‑MEDICARE.
Section-by-Section Breakdown
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Short title
Names the legislation the "Connecting Caregivers to Medicare Act of 2025." This is purely formal but signals the bill’s focus on caregiver access and outreach rather than benefit changes.
New outreach and education duty for caregiver access
Adds a new subsection that obligates the Secretary to run outreach and education so beneficiaries, applicants, providers, caregivers, and other stakeholders know about the option to authorize a family caregiver to access the beneficiary's personal health information through 1‑800‑MEDICARE once the beneficiary completes CMS–10106 (or a successor). This is an operational mandate: CMS must plan and execute communication campaigns across multiple channels rather than merely issuing a high‑level statement.
Where and how CMS must present the authorization option
Specifies that CMS must make the option and the authorization form prominent, accessible, and readily understandable in the subsection (a) notice (the statutorily required Medicare notice), on Medicare.gov, through Medicare Advantage outreach, and by other platforms the Secretary selects (for example, social media). It also requires CMS to embed fraud‑prevention best practices into those materials. Practically, CMS will need to revise templates, web pages, and MA communications and define what "prominent" means in operational guidance.
OIG‑led fraud guidance and caregiver feedback
Directs the Office of Inspector General to produce and publish best practices within one year to protect beneficiaries from fraud linked to caregiver access, and requires separate best‑practice sets for beneficiaries, caregivers, providers, and other entities as appropriate. It also requires CMS to provide caregiver feedback opportunities (for example, surveys). These provisions task oversight and quality functions to the OIG and obligate CMS to build mechanisms to collect and incorporate user feedback.
Language access, coordination, and legal definitions
Mandates non‑English availability of outreach materials and the authorization form as the Secretary specifies, encourages coordination with State Health Insurance Assistance Programs and the Administration for Community Living, and adopts the RAISE Act definition of "family caregiver" while allowing the Secretary to add others. It also names the CMS–10106 form as the specified authorization form (or a successor), anchoring practice to an existing CMS form but leaving room for updates.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Family caregivers — they get a clear, standardized federal pathway (via CMS–10106 and 1‑800‑MEDICARE) to request and receive Medicare‑related personal health information, plus trained call‑center assistance.
- Medicare beneficiaries who want authorized help — standardization reduces friction when delegating access and makes it more likely caregivers can obtain information to coordinate care.
- 1‑800‑MEDICARE operators and CMS outreach teams — the bill provides a single, agency‑approved process and materials for handling caregiver access requests, reducing ad‑hoc practices across calls and web interactions.
- Non‑English‑speaking beneficiaries and caregivers — mandated language availability should improve access where translated materials are provided.
Who Bears the Cost
- CMS and the 1‑800‑MEDICARE program — they must build, translate, and maintain new materials, revise enrollment notices and web content, train call operators, and handle additional call volume and administrative workflows.
- HHS Office of Inspector General and investigators — OIG must develop best practices within a one‑year deadline and may face higher investigative caseloads if reporting rises.
- Medicare Advantage plans and provider organizations — though not direct fiscal obligors, they must be included in outreach and may need to align their communications and consent processes, increasing coordination costs.
- State SHIPs and community partners — expected coordination increases workload for programs that already have constrained capacity unless CMS provides support.
Key Issues
The Core Tension
The central dilemma is straightforward: the bill expands practical access for family caregivers (improving care coordination and reducing barriers) while increasing the risk of improper access and fraud and imposing material operational burdens on CMS, call centers, and investigators—trade‑offs that depend on how strictly CMS defines authentication, language access, and the form’s role in authorizing disclosures.
The bill creates a usable, centralized path for caregiver access but leaves key implementation decisions to CMS and the OIG. It instructs the OIG to publish best practices within a year, yet it does not appropriate funds, set standards for translations, or define what "prominent, easily accessible, and readily understandable" means in practice.
That ambiguity forces CMS to make interpretive choices about design, placement, and language thresholds, which will determine how effective outreach is and whether underserved populations actually benefit.
A second tension is the interaction between increased caregiver access and privacy/fraud risk. The statute directs fraud‑prevention guidance but does not modify HIPAA or create new enforcement mechanisms; it relies on existing reporting channels and the OIG’s recommendations.
Operationalizing caregiver authorizations through a phone‑based channel raises authentication and verification questions — for example, what identity proof is sufficient when a caregiver calls, how to track and audit disclosures, and how to reconcile conflicting state or plan‑level authorizations. Those practicalities will affect both beneficiary privacy and the workload of call centers and investigators.
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