# 119-s-3491: Black Lung Benefits Improvement Act of 2025

119-s-3491, Black Lung Benefits Improvement Act of 2025, is a 119th Congress bill sponsored by Sen. Kaine, Tim [D-VA] (D-VA); status introduced; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-s-3491
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-3491
- Congress: 119
- Title: Black Lung Benefits Improvement Act of 2025
- Status: introduced
- Introduced: 2025-12-16
- Sponsor: Sen. Kaine, Tim [D-VA] (D-VA)
- Cosponsors: 2
- Policy area: Labor and Employment
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**This bill would guarantee each resident the right to designate and have access to one or more *essential caregivers* in Medicare skilled nursing facilities and Medicaid nursing facilities, including during periods when visitation is restricted.** It would set clear limits on when facilities can deny access and create a fast appeals and state oversight process to enforce those rights. - Residents and families: Residents could name one or more essential caregivers and a representative can name a caregiver for residents with cognitive impairment. Facilities must allow at least one caregiver daily and permit access at all times during emergency visitation restrictions, with special rules for end-of-life and decline or distress situations. - Facilities and staff: Facilities must put written safety protocols in place that are no more restrictive than staff rules. A facility may initially deny access for up to 7 days and extend denial up to 7 more days only with State survey agency approval, for a 14-day cap during any single emergency. - State oversight and appeals: The State survey agency must accept appeals and start investigations within two business days, decide within 48 hours of starting an investigation, order immediate access if violations are found, require corrective action within 7 days, and may impose civil money penalties up to $5,000 for failure to comply. The Secretary would issue a final rule on appeals within two years and the law would take effect two years after enactment.

## Cosponsors (2)

- Sen. Warner, Mark R. [D-VA] (D-VA), 2025-12-16T00:00:00.000Z
- Sen. Fetterman, John [D-PA] (D-PA), 2025-12-16T00:00:00.000Z

## Provisions PRIA read

- Faster appeals for caregiver denials: benefit, medium. If enacted, the Secretary would issue a final rule within two years to set up an appeals process. State survey agencies would have to begin investigating appeals within two business days and decide within 48 hours of starting. If the agency finds a violation, the facility would have to allow immedi…
- Residents can name essential caregivers: benefit, medium. If enacted, residents in skilled nursing facilities would be able to designate one or more essential caregivers. A resident representative could name a caregiver for residents with cognitive or mental disability. Caregivers would need to follow the facility's written safety protocols, which could n…
- Caregiver access during emergency restrictions: mixed, medium. If enacted, during emergency periods when visitation is restricted (starting two years after enactment) facilities would generally have to allow in-person access by essential caregivers. They would have to permit at least one essential caregiver daily and allow access at any time, and provide reaso…

## Related bills

- 119-s-51: Washington, D.C. Admission Act
- 119-s-5108: Right to IVF Act of 2026
- 119-s-1503: Equality Act
- 119-s-2819: Head Start for America's Children Act
- 119-s-1748: Kids Online Safety Act
- 119-sres-854: A resolution designating September 2026 as "National Voting Rights Month".

## Sources
- [119-s-3491 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/3491)

## Related
- [119-s-51: Washington, D.C. Admission Act](https://policyrisk.com/legislation/119-s-51)
- [119-s-5108: Right to IVF Act of 2026](https://policyrisk.com/legislation/119-s-5108)
- [119-s-1503: Equality Act](https://policyrisk.com/legislation/119-s-1503)
- [119-s-2819: Head Start for America's Children Act](https://policyrisk.com/legislation/119-s-2819)
- [119-s-1748: Kids Online Safety Act](https://policyrisk.com/legislation/119-s-1748)
- [119-sres-854: A resolution designating September 2026 as "National Voting Rights Month".](https://policyrisk.com/legislation/119-sres-854)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-3491 (as of 2026-04-21).