I 

113TH CONGRESS 

1ST SESSION H. R. 2524 

To establish a program to provide incentive payments to participating 

Medicare beneficiaries who voluntarily establish and maintain better health. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 26, 2013 

Mr. PAULSEN (for himself, Mr. KIND, Mr. GRIFFIN of Arkansas, and Ms. 

FUDGE) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To establish a program to provide incentive payments to 

participating Medicare beneficiaries who voluntarily establish and maintain better health. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Better 

5 Health Rewards Program Act of 2013’’. 


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1 SEC. 2. MEDICARE BETTER HEALTH REWARDS PROGRAM. 

2 Part B of title XVIII of the Social Security Act (42 

3 U.S.C. 1395j et seq.) is amended by adding at the end 

4 the following new section: 

5 ‘‘MEDICARE BETTER HEALTH REWARDS PROGRAM

6 ‘‘SEC. 1849. (a) IN GENERAL.—The Secretary shall 

7 establish a Better Health Rewards Program (in this sec8 tion referred to as the ‘Program’) under which incentives 

9 are provided to Medicare beneficiaries who voluntarily 

10 agree to participate in the Program. 

11 ‘‘(b) ENROLLMENT.—A health professional partici12 pating in the Program shall provide their patients who are 

13 Medicare beneficiaries with a description of and an oppor14 tunity to enroll in the Program on a voluntary basis. If 

15 a Medicare beneficiary elects to enroll in the Program, the 

16 health professional shall inform the Secretary of the indi17 vidual’s enrollment through a process established by the 

18 Secretary, which does not impose additional administra19 tive requirements on the participating health professional. 

20 ‘‘(c) ESTABLISHMENT OF BETTER HEALTH TARGET

21 STANDARDS.— 

22 ‘‘(1) IN GENERAL.— 

23 ‘‘(A) ESTABLISHMENT.—The Secretary 

24 shall establish standards for measuring better 

25 health targets and points for achieving such 

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1 ficiaries, including such standards and points 

2 with respect to the following: 

3 ‘‘(i) Annual wellness visit. 

4 ‘‘(ii) Tobacco cessation. 

5 ‘‘(iii) Body Mass Index (BMI). 

6 ‘‘(iv) Diabetes screening test. 

7 ‘‘(v) Cardiovascular disease screening. 

8 ‘‘(vi) Cholesterol level screening. 

9 ‘‘(vii) Screening tests and specified 

10 vaccinations. 

11 ‘‘(B) CONSULTATION.—In establishing 

12 standards and points for achieving such stand13 ards under this subsection, the Secretary— 

14 ‘‘(i) shall consult with 1 or more na15 tionally recognized health care quality or16 ganizations, as determined appropriate by 

17 the Secretary; and 

18 ‘‘(ii) may consult with physicians and 

19 other professionals experienced with well20 ness programs. 

21 ‘‘(C) POINTS.—The number of points 

22 awarded for a year for achieving standards with 

23 respect to each of the targets described in 

24 clauses (i) through (vii) of subparagraph (A) 

25 shall not exceed 5. Such points may be awarded 


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1 on a sliding scale, based on standards estab2 lished under this subsection, as determined ap3 propriate by the Secretary. 

4 ‘‘(2) MODIFICATION OF BETTER HEALTH TAR5 GET STANDARDS AND ASSIGNED POINTS.— 

6 ‘‘(A) IN GENERAL.—The Secretary may 

7 modify standards for measuring better health 

8 targets and, subject to paragraph (1)(C), points 

9 for achieving such standards for participating 

10 Medicare beneficiaries under this subsection. 

11 ‘‘(B) CONSULTATION.—In modifying 

12 standards and points for achieving such stand13 ards under this paragraph, the Secretary— 

14 ‘‘(i) shall consult with 1 or more na15 tionally recognized health care quality or16 ganizations, as determined appropriate by 

17 the Secretary; and 

18 ‘‘(ii) may consult with physicians and 

19 other professionals experienced with well20 ness programs. 

21 ‘‘(d) CONDUCT OF PROGRAM.— 

22 ‘‘(1) DURATION.— 

23 ‘‘(A) IN GENERAL.—Subject to subpara24 graph (B), the Program shall be conducted for 

25 not less than a 3-year period. 


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1 ‘‘(B) EXPANSION.—The Secretary shall ex2 pand the duration and scope of the Program, to 

3 the extent determined appropriate by the Sec4 retary, if— 

5 ‘‘(i) the Secretary determines that 

6 such expansion is expected to— 

7 ‘‘(I) reduce spending under this 

8 title without reducing the quality of 

9 care; or 

10 ‘‘(II) improve the quality of care 

11 and reduce spending; 

12 ‘‘(ii) the Chief Actuary of the Centers 

13 for Medicare & Medicaid Services certifies 

14 that such expansion would reduce program 

15 spending under this title; and 

16 ‘‘(iii) the Secretary determines that 

17 such expansion would not deny or limit the 

18 coverage or provision of benefits under this 

19 title for individuals. 

20 ‘‘(2) COLLECTION AND USE OF BASELINE

21 DATA.—During the first year of the Program, a 

22 health professional shall establish and report to the 

23 Secretary baseline information for each participating 

24 Medicare beneficiary who is a patient of the health 

25 professional as part of that beneficiary’s first year 


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1 assessment under paragraph (3)(A). The health pro2 fessional shall use such data to aid in the determina3 tion of whether and to what extent the participating 

4 Medicare beneficiary is meeting the target standards 

5 under subsection (c) in each of years 2 and 3 of the 

6 Program. 

7 ‘‘(3) REQUIRED ASSESSMENTS FOR PARTICI8 PATING MEDICARE BENEFICIARIES.— 

9 ‘‘(A) FIRST YEAR.—During year 1 of the 

10 Program, a health professional shall furnish to 

11 each participating Medicare beneficiary that is 

12 a patient of the health professional either an 

13 annual wellness visit or an initial preventive 

14 physical examination. 

15 ‘‘(B) SECOND AND THIRD YEARS.—During 

16 each of years 2 and 3 of the Program, a health 

17 professional shall furnish to each participating 

18 Medicare beneficiary that is a patient of the 

19 health professional an annual wellness visit to 

20 determine whether and to what extent the par21 ticipating Medicare beneficiary has met the tar22 get standards under subsection (c). 

23 ‘‘(e) DETERMINATION OF POINTS AND PAYMENT OF

24 INCENTIVES.— 


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1 ‘‘(1) DETERMINATION OF POINTS.—During 

2 each of years 2 and 3 of the Program, a health pro3 fessional shall— 

4 ‘‘(A) evaluate and report to the Secretary 

5 whether each participating Medicare beneficiary 

6 that is a patient of the health professional has 

7 achieved the target standards under subsection 

8 (c); and 

9 ‘‘(B) determine the total amount of points 

10 that each such participating Medicare bene11 ficiary has achieved for the year based on the 

12 points assigned for achieving such standards 

13 under subsection (c). 

14 ‘‘(2) INCENTIVE PAYMENT.— 

15 ‘‘(A) IN GENERAL.—The Secretary shall 

16 pay to each participating Medicare beneficiary 

17 who achieves at least 20 points under para18 graph (1)(B) for the year an incentive payment. 

19 Such payment shall be equal to an amount de20 termined appropriate by the Secretary, but no 

21 case shall such amount exceed the following: 

‘‘Points Year 2 Payment 

Amount 

Year 3 or a Subsequent 

Year Payment Amount 

20–24 points ...................... $100 $200

25 or more points .............. $200 $400. 


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1 ‘‘(B) INFLATION ADJUSTMENT.—The dol2 lar amounts specified in this paragraph shall be 

3 increased, beginning with 2017, from year to 

4 year based on the percentage increase in the 

5 consumer price index for all urban consumers 

6 (all items; United States city average), rounded 

7 to the nearest $1. 

8 ‘‘(3) FINAL DETERMINATION OF STANDARDS

9 ACHIEVEMENT MADE BY PARTICIPATING HEALTH

10 PROFESSIONAL.—Under the Program, a partici11 pating health professional shall make the final deter12 mination as to whether or not a participating Medi13 care beneficiary has met the target standards under 

14 subsection (c) and what screening tests and specified 

15 vaccinations, or other services, are necessary for 

16 purposes of making such determination. 

17 ‘‘(f) SPENDING BENCHMARKS.— 

18 ‘‘(1) IN GENERAL.—The Secretary shall collect 

19 relevant data, including data on claims paid under 

20 this title for services furnished to participating 

21 Medicare beneficiaries during the Program, for pur22 poses of determining the aggregate estimated sav23 ings achieved under this title for participating Medi24 care beneficiaries during each of years 2 and 3 of 

25 the Program in accordance with paragraph (2) (and 


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1 for a subsequent year if the Program is expanded 

2 under subsection (d)(1)(B)). 

3 ‘‘(2) DETERMINATION OF AGGREGATE ESTI4 MATED SAVINGS.— 

5 ‘‘(A) IN GENERAL.—The amount of the 

6 aggregate estimated savings under this title for 

7 participating Medicare beneficiaries under para8 graph (1), with respect to a year, shall be equal 

9 to— 

10 ‘‘(i) the estimated savings determined 

11 under subparagraph (B) for the year; 

12 minus 

13 ‘‘(ii) the aggregate incentive payments 

14 made under the Program during the year. 

15 ‘‘(B) DETERMINATION OF ESTIMATED SAV16 INGS.—For purposes of subparagraph (A)(i), 

17 the estimated savings determined under this 

18 subparagraph for a year shall be equal to— 

19 ‘‘(i) the estimated aggregate expendi20 tures under this title (as projected under 

21 subparagraph (C)) for the year; minus 

22 ‘‘(ii) the actual aggregate expendi23 tures under this title (as determined by the 

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1 ticipating Medicare beneficiaries) for the 

2 year. 

3 ‘‘(C) PROJECTION OF ESTIMATED AGGRE4 GATE CLAIMS COST.— 

5 ‘‘(i) BENCHMARK BASE YEAR.—The 

6 Secretary shall establish a benchmark base 

7 year amount of expenditures under this 

8 title for participating Medicare bene9 ficiaries during year 1 of the Program. 

10 ‘‘(ii) PROJECTION.—The Secretary 

11 shall use the benchmark base year amount 

12 established under clause (i) to project the 

13 estimated aggregate expenditures for all 

14 participating Medicare beneficiaries during 

15 each of years 2 and 3 of the Program as 

16 if the beneficiaries were not participating 

17 in the Program. In making such projec18 tion, the Secretary may include adjust19 ments for health status or other specific 

20 risk factors and geographic variation for 

21 the participating Medicare beneficiaries. 

22 ‘‘(D) PUBLIC REPORT OF DETERMINATION

23 AND OTHER PROGRAM INFORMATION.—Not 

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1 graph (A) with respect to a year, the Secretary 

2 shall make available to the public a report con3 taining a description of the amount of the sav4 ings determined, including the methodology and 

5 any other calculations or determinations in6 volved in the determination of such amount. 

7 Such report shall include— 

8 ‘‘(i) a description of any reduction in 

9 specific health risks of participating Medi10 care beneficiaries identified by the Sec11 retary; 

12 ‘‘(ii) a description of— 

13 ‘‘(I) standards for measuring bet14 ter health targets under subsection 

15 (c); and 

16 ‘‘(II) the points available for 

17 achieving each such standard under 

18 that subsection; and 

19 ‘‘(iii) recommendations for such legis20 lation and administrative action as the 

21 Secretary determines appropriate. 

22 ‘‘(3) MONITORING OF PROGRAM COSTS.—Dur23 ing the operation of the Program, the Chief Actuary 

24 of the Centers for Medicare & Medicaid Services 

25 shall— 


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1 ‘‘(A) monitor the Program to determine 

2 whether or not the Program is reducing aggre3 gate expenditures under this title; and 

4 ‘‘(B) submit to the Secretary an annual re5 port on the results of such monitoring. 

6 ‘‘(4) REQUIRED ACTION IF AGGREGATE INCEN7 TIVE PAYMENTS EXCEED SAVINGS.—If the Sec8 retary, taking into account the reports under para9 graph (3)(B), determines that the aggregate expend10 itures under this title exceed the aggregate expendi11 tures under this title that would have been made if 

12 the Program had not been implemented, the Sec13 retary shall provide for changes to the provisions of 

14 the program in order to eliminate such excess. 

15 ‘‘(g) WAIVER AUTHORITY.—The Secretary may 

16 waive such requirements of titles XI and XVIII as may 

17 be necessary to carry out the purposes of the Program 

18 established under this section. 

19 ‘‘(h) DEFINITIONS.—In this section: 

20 ‘‘(1) ANNUAL WELLNESS VISIT.—The term ‘an21 nual wellness visit’ includes personalized prevention 

22 plan services (as defined in section 1861(hhh)(1)). 

23 ‘‘(2) HEALTH PROFESSIONAL.—The term 

24 ‘health professional’ includes a physician (as defined 


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1 in section 1861(r)(1)) and a practitioner described 

2 in clause (i) of section 1842(b)(18)(C). 

3 ‘‘(3) INITIAL PREVENTIVE PHYSICAL EXAMINA4 TION.—The term ‘initial preventive physical exam5 ination’ has the meaning given that term in section 

6 1861(ww)(1). 

7 ‘‘(4) MEDICARE BENEFICIARY.—The term 

8 ‘Medicare beneficiary’ means an individual enrolled 

9 in part B. 

10 ‘‘(5) PARTICIPATING MEDICARE BENE11 FICIARY.—The term ‘participating Medicare bene12 ficiary’ means a Medicare beneficiary who enrolls in 

13 the Program under subsection (b). 

14 ‘‘(6) SCREENING TESTS.—The term ‘screening 

15 tests’ means any of the following that are deter16 mined by a health professional to be appropriate for 

17 a participating Medicare beneficiary: 

18 ‘‘(A) Colorectal cancer screening tests (as 

19 defined in section 1861(pp)). 

20 ‘‘(B) Screening mammography (as de21 scribed in section 1861(jj)). 

22 ‘‘(C) Screening pap smear and screening 

23 pelvic exam (as defined in section 1861(nn)). 

24 ‘‘(D) Screening for glaucoma (as defined 

25 in section 1861(uu)). 


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1 ‘‘(E) Bone mass measurement (as defined 

2 in section 1861(rr)) for qualified individuals de3 scribed in paragraph (2)(A) of such section. 

4 ‘‘(F) HIV screening for high-risk groups 

5 (as identified by the Secretary). 

6 ‘‘(7) SPECIFIED VACCINATIONS.—The term 

7 ‘specified vaccinations’ means the vaccinations de8 scribed in section 1861(ww)(1) that are determined 

9 by a health professional to be appropriate for a par10 ticipating Medicare beneficiary.’’. 

11 SEC. 3. PARTICIPATION BY MEDICARE ADVANTAGE PLANS. 

12 Section 1859 of the Social Security Act (42 U.S.C. 

13 1395w–28) is amended by adding at the end the following 

14 new subsection: 

15 ‘‘(h) PROVIDING INCENTIVES FOR VOLUNTARY PAR16 TICIPATION IN A BETTER HEALTH REWARDS PRO17 GRAM.— 

18 ‘‘(1) IN GENERAL.—Effective for plan years be19 ginning on or after the date of enactment of the 

20 Medicare Better Health Rewards Program Act of 

21 2013, a Medicare Advantage organization may pro22 vide to individuals enrolled in an MA plan offered by 

23 the organization incentive payments, including cash, 

24 cash-equivalent, or other types of incentives, for vol25 untary participation in a Better Health Rewards 


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1 Program (in this subsection referred to as the ‘Pro2 gram’) that rewards individuals for meeting certain 

3 health targets established by the Secretary. 

4 ‘‘(2) LIMITATION.—In no case shall the month5 ly bid amount submitted by a Medicare Advantage 

6 organization under section 1834(a)(6) (or the 

7 monthly premium charged by the organization under 

8 section 1854(b)) with respect to an MA plan offered 

9 by the organization take into account any incentive 

10 payments made to enrollees under the Program. 

11 ‘‘(3) IMPLEMENTATION.—The Program under 

12 this subsection shall be conducted in a similar man13 ner to the manner in which the program under sec14 tion 1849 is conducted, in accordance with stand15 ards established by the Secretary. 

16 ‘‘(4) NOTIFICATION AND PROVISION OF INFOR17 MATION.—A Medicare Advantage organization seek18 ing to participate in the Program shall— 

19 ‘‘(A) notify the Secretary of the organiza20 tion’s intent to participate in the Program; and 

21 ‘‘(B) agree to provide to the Secretary— 

22 ‘‘(i) information regarding— 

23 ‘‘(I) which enrollees participate 

24 in the Program; 


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1 ‘‘(II) the scores of those enrollees 

2 with respect to applicable health tar3 gets under the Program; and 

4 ‘‘(III) the incentives enrollees re5 ceive for meeting such health targets; 

6 and 

7 ‘‘(ii) any other information specified 

8 by the Secretary for purposes of this sub9 section. 

10 ‘‘(5) WAIVER AUTHORITY.—The Secretary may 

11 waive such requirements of titles XI and XVIII as 

12 may be necessary to carry out the purposes of the 

13 Program established under this subsection.’’. 

14 SEC. 4. PARTICIPATION OF SECTION 1876 COST PLANS. 

15 Section 1876 of the Social Security Act (42 U.S.C. 

16 1395mm) is amended by inserting at the end the fol17 lowing: 

18 ‘‘(l) PROVIDING INCENTIVES FOR VOLUNTARY PAR19 TICIPATION IN A BETTER HEALTH REWARDS PRO20 GRAM.— 

21 ‘‘(1) IN GENERAL.—Effective for contract peri22 ods beginning on or after the date of enactment of 

23 the Medicare Better Health Rewards Program Act 

24 of 2013, an eligible organization may provide to 

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1 zation incentive payments, including cash, cash2 equivalent, or other types of incentives, for voluntary 

3 participation in a Better Health Rewards Program 

4 (in this subsection referred to as the ‘Program’) that 

5 rewards members for meeting certain health targets 

6 established by the Secretary. 

7 ‘‘(2) LIMITATION.—In no case shall the pay8 ment to an eligible organization under this section 

9 (or the premium rate charged by the organization 

10 under this section) with respect to members enrolled 

11 with the organization take into account any incentive 

12 payments made to members under the Program. 

13 ‘‘(3) IMPLEMENTATION.—The Program under 

14 this subsection shall be conducted in a similar man15 ner to the manner in which the program under sec16 tion 1849 is conducted, in accordance with stand17 ards established by the Secretary. 

18 ‘‘(4) NOTIFICATION AND PROVISION OF INFOR19 MATION.—An eligible organization seeking to partici20 pate in the Program shall— 

21 ‘‘(A) notify the Secretary of the organiza22 tion’s intent to participate in the Program; and 

23 ‘‘(B) agree to provide to the Secretary— 

24 ‘‘(i) information regarding— 


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1 ‘‘(I) which members participate 

2 in the Program; 

3 ‘‘(II) the scores of those members 

4 with respect to applicable health tar5 gets under the Program; and 

6 ‘‘(III) the incentives members re7 ceive for meeting such health targets; 

8 and 

9 ‘‘(ii) any other information specified 

10 by the Secretary for purposes of this sub11 section. 

12 ‘‘(5) WAIVER AUTHORITY.—The Secretary may 

13 waive such requirements of titles XI and XVIII as 

14 may be necessary to carry out the purposes of the 

15 Program established under this subsection.’’. 

16 SEC. 5. PARTICIPATION OF PROGRAMS OF ALL-INCLUSIVE 

17 CARE FOR THE ELDERLY (PACE). 

18 (a) MEDICARE.—Section 1894 of the Social Security 

19 Act (42 U.S.C. 1395eee) is amended by adding at the end 

20 the following new subsection: 

21 ‘‘(j) PROVIDING INCENTIVES FOR VOLUNTARY PAR22 TICIPATION IN A BETTER HEALTH REWARDS PRO23 GRAM.— 

24 ‘‘(1) IN GENERAL.—Effective for PACE pro25 gram agreements entered into on or after the date 


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1 of enactment of the Medicare Better Health Re2 wards Program Act of 2013, a PACE provider may 

3 provide to PACE program eligible individuals en4 rolled under this section with the PACE provider in5 centive payments, including cash, cash-equivalent, or 

6 other types of incentives, for voluntary participation 

7 in a Better Health Rewards Program (in this sub8 section referred to as the ‘Program’) that rewards 

9 enrollees for meeting certain health targets estab10 lished by the Secretary. 

11 ‘‘(2) LIMITATION.—In no case shall the pay12 ment to a PACE provider under this section (or any 

13 premium charged by the provider under this section) 

14 with respect to PACE program eligible individuals 

15 enrolled with the PACE provider take into account 

16 any incentive payments made to individuals under 

17 the Program. 

18 ‘‘(3) IMPLEMENTATION.—The Program under 

19 this subsection shall be conducted in a similar man20 ner to the manner in which the program under sec21 tion 1849 is conducted, in accordance with stand22 ards established by the Secretary. 

23 ‘‘(4) NOTIFICATION AND PROVISION OF INFOR24 MATION.—A PACE provider seeking to participate 

25 in the Program shall— 


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1 ‘‘(A) notify the Secretary of the PACE 

2 provider’s intent to participate in the Program; 

3 and 

4 ‘‘(B) agree to provide to the Secretary— 

5 ‘‘(i) information regarding— 

6 ‘‘(I) which PACE program eligi7 ble individuals enrolled with the 

8 PACE provider participate in the Pro9 gram; 

10 ‘‘(II) the scores of those individ11 uals with respect to applicable health 

12 targets under the Program; and 

13 ‘‘(III) the incentives individuals 

14 receive for meeting such health tar15 gets; and 

16 ‘‘(ii) any other information specified 

17 by the Secretary for purposes of this sub18 section. 

19 ‘‘(5) WAIVER AUTHORITY.—The Secretary may 

20 waive such requirements of titles XI, XVIII, and 

21 XIX as may be necessary to carry out the purposes 

22 of the Program established under this subsection.’’. 

23 (b) MEDICAID.—Section 1934 of the Social Security 

24 Act (42 U.S.C. 1396u–4) is amended by adding at the 

25 end the following new subsection: 


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1 ‘‘(k) PROVIDING INCENTIVES FOR VOLUNTARY PAR2 TICIPATION IN A BETTER HEALTH REWARDS PRO3 GRAM.— 

4 ‘‘(1) IN GENERAL.—Effective for PACE pro5 gram agreements entered into on or after the date 

6 of enactment of the Medicare Better Health Re7 wards Program Act of 2013, a PACE provider may 

8 provide to PACE program eligible individuals en9 rolled under this section with the PACE provider in10 centive payments, including cash, cash-equivalent, or 

11 other types of incentives, for voluntary participation 

12 in a Better Health Rewards Program (in this sub13 section referred to as the ‘Program’) that rewards 

14 enrollees for meeting certain health targets estab15 lished by the Secretary. 

16 ‘‘(2) LIMITATION.—In no case shall the pay17 ment to a PACE provider under this section (or any 

18 premium charged by the provider under this section) 

19 with respect to PACE program eligible individuals 

20 enrolled with the PACE provider take into account 

21 any incentive payments made to individuals under 

22 the Program. 

23 ‘‘(3) IMPLEMENTATION.—The Program under 

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1 tion 1849 is conducted, in accordance with stand2 ards established by the Secretary. 

3 ‘‘(4) NOTIFICATION AND PROVISION OF INFOR4 MATION.—A PACE provider seeking to participate 

5 in the Program shall— 

6 ‘‘(A) notify the Secretary of the PACE 

7 provider’s intent to participate in the Program; 

8 and 

9 ‘‘(B) agree to provide to the Secretary— 

10 ‘‘(i) information regarding— 

11 ‘‘(I) which PACE program eligi12 ble individuals enrolled with the 

13 PACE provider participate in the Pro14 gram; 

15 ‘‘(II) the scores of those individ16 uals with respect to applicable health 

17 targets under the Program; and 

18 ‘‘(III) the incentives individuals 

19 receive for meeting such health tar20 gets; and 

21 ‘‘(ii) any other information specified 

22 by the Secretary for purposes of this sub23 section. 

24 ‘‘(5) WAIVER AUTHORITY.—The Secretary may 

25 waive such requirements of titles XI, XVIII, and 


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1 XIX as may be necessary to carry out the purposes 

2 of the Program established under this subsection.’’. 

3 SEC. 6. EXCLUSION OF INCENTIVE PAYMENTS. 

4 (a) IN GENERAL.—Part III of subchapter B of chap5 ter 1 of the Internal Revenue Code of 1986 is amended 

6 by inserting after section 139D the following new section: 

7 ‘‘SEC. 139E. MEDICARE BETTER HEALTH REWARDS PAY8 MENTS. 

9 ‘‘Gross income shall not include any payment made 

10 under the following programs: 

11 ‘‘(1) The Medicare Better Health Rewards Pro12 gram established under section 1849 of the Social 

13 Security Act. 

14 ‘‘(2) A Better Health Rewards Program estab15 lished pursuant to section 1859(h), 1876(l), 1894(j), 

16 or 1934(k) of the Social Security Act.’’. 

17 (b) CLERICAL AMENDMENT.—The table of sections 

18 for part III of subchapter B of chapter 1 of such Code 

19 is amended by inserting after the item relating to section 

20 139D the following new item: 

‘‘Sec. 139E. Medicare Better Health Rewards payments.’’. 

Æ 


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