I 

116TH CONGRESS 

1ST SESSION H. R. 3436 

To amend title XVIII of the Social Security Act to remove cost-sharing 

responsibilities for chronic care management services under the Medicare 

program. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 24, 2019 

Ms. DELBENE (for herself and Mr. WELCH) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, 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 amend title XVIII of the Social Security Act to remove 

cost-sharing responsibilities for chronic care management 

services under the Medicare program. 

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 ‘‘Chronic Care Manage5 ment Improvement Act’’. 


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1 SEC. 2. REMOVING COST-SHARING RESPONSIBILITIES FOR 

2 CHRONIC CARE MANAGEMENT SERVICES 

3 UNDER PART B OF THE MEDICARE PROGRAM. 

4 (a) IN GENERAL.—Section 1833 of the Social Secu5 rity Act (42 U.S.C. 1395l) is amended— 

6 (1) in subsection (a)(1), by striking subpara7 graph (Z) and inserting the following: ‘‘(Z) with re8 spect to chronic care management services (as de9 scribed in section 1848(b)(8)) furnished on or after 

10 January 1, 2021, the amount paid shall be an 

11 amount equal to 100 percent of the lesser of the ac12 tual charge for such services or the amount deter13 mined under section 1848,’’; and 

14 (2) in subsection (b)— 

15 (A) in paragraph (9), by striking ‘‘and’’ at 

16 the end; and 

17 (B) in paragraph (10), by striking the pe18 riod at the end and inserting the following: ‘‘, 

19 and (11) such deductible shall not apply with 

20 respect to chronic care management services (as 

21 described in section 1848(b)(8)) furnished on or 

22 after January 1, 2021.’’. 

23 (b) TECHNICAL AMENDMENTS.— 

24 (1) IN GENERAL.—Section 1833(a) of the So25 cial Security Act (42 U.S.C. 1395l(a)) is amended— 

26 (A) in paragraph (3)— 


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1 (i) in subparagraph (A)— 

2 (I) by striking ‘‘subparagraph 

3 (B)’’ and inserting ‘‘subparagraphs 

4 (B), (C), and (D)’’; and 

5 (II) by striking ‘‘or’’ at the end; 

6 and 

7 (ii) by adding at the end the following 

8 new subparagraphs: 

9 ‘‘(C) with respect to Federally qualified 

10 health center services (other than such services 

11 that are described in clause (i) or (ii) of sub12 paragraph (D)) furnished on or after the imple13 mentation date of the prospective payment sys14 tem under section 1834(o) for which payment is 

15 made under such section, the amounts paid 

16 shall be 80 percent of the lesser of the actual 

17 charge or the amount determined under such 

18 section; and 

19 ‘‘(D) with respect to Federally qualified 

20 health center services and rural health clinic 

21 services that are— 

22 ‘‘(i) personalized prevention plan serv23 ices (as described in paragraph (1)(X)) or 

24 preventive services (as described in paraVerDate Sep 11 2014 01:07 Jun 29, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3436.IH H3436

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1 graph (1)(Y)) furnished on or after Janu2 ary 1, 2011; or 

3 ‘‘(ii) chronic care management serv4 ices (as described in paragraph (1)(Z)) 

5 furnished on or after January 1, 2021; 

6 the amounts paid shall be equal to 100 percent 

7 of the lesser of the actual charge or the amount 

8 determined under subparagraph (A), section 

9 1834(o), or section 1848, as applicable);’’; and 

10 (B) by striking the matter following para11 graph (9). 

12 (2) CONFORMING AMENDMENTS.—Section 

13 1834(o) of the Social Security Act (42 U.S.C. 

14 1395m(o)) is amended— 

15 (A) in paragraph (1)(A), by inserting 

16 ‘‘(other than such services described in clause 

17 (i) or (ii) of section 1833(a)(3)(D))’’ after 

18 ‘‘Federally qualified health center services’’; 

19 and 

20 (B) in paragraph (2)— 

21 (i) in subparagraph (A), by inserting 

22 ‘‘(other than such services described in 

23 clause (i) or (ii) of section 1833(a)(3)(D))’’ 

24 after ‘‘services’’; and 

25 (ii) in subparagraph (B)(i)— 


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1 (I) by inserting ‘‘(other than 

2 such services described in clause (i) or 

3 (ii) of section 1833(a)(3)(D))’’ after 

4 ‘‘Federally qualified health center 

5 services’’; and 

6 (II) by striking ‘‘section 

7 1833(a)(1)(Z)’’ and inserting ‘‘sub8 paragraphs (C) and (D) of section 

9 1833(a)(3)’’. 

Æ 


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