Assessing Critical Care Efforts to Strengthen Services (ACCESS) Act of 2017

To amend title XI of the Social Security Act to provide through the Center for Medicare and Medicaid Innovation (CMMI) for a Medicaid payment model demonstration project on Medicaid reimbursement for physicians’ services in counties with a disproportionately high proportion of Medicaid enrollees. 1. Short title This Act may be cited as the Assessing Critical Care Efforts to Strengthen Services (ACCESS) Act of 2017 2. CMMI Medicaid payment model demonstration project on Medicaid reimbursement for physicians’ services in counties with a disproportionately high proportion of Medicaid enrollees Section 1115A(b) of the Social Security Act ( 42 U.S.C. 1315a(b) (1) in paragraph (2)(B), by adding at the end the following new clause: (xxv) Focusing on payment models under title XIX for recruiting and retaining physicians to serve low-income applicable individuals residing in disproportionate share counties (as defined in paragraph (5)(D)). ; and (2) by adding at the end the following new paragraph: (5) Medicaid physicians’ service model for low-income individuals in disproportionate share counties (A) Selection Beginning not later than 6 months after the date of the enactment of this paragraph, the Secretary shall select for testing one or more models described in paragraph (2)(B)(xxv). (B) Design In selecting, and designing the testing for, such a model under this subsection, CMI shall— (i) review the most successful models for recruiting and retaining physicians to serve low-income applicable individuals residing in a disproportionate share county (as defined in subparagraph (D)); and (ii) incorporate lessons from successful strategies that take into account how access to physicians’ services has improved for such individuals. (C) Evaluation In evaluating the performance of such a model under paragraph (4), CMI shall— (i) evaluate the applicability and expansion of the model to inform national strategies to best leverage funds under title XIX to improve access to physicians’ services for low-income applicable individuals residing in a disproportionate share county; and (ii) examine the degree to which Medicaid payment strategies (such as the use of primary case management, medical homes, and palliative care, the use of payment rates for physicians’ services that are not less than the Medicare payment rates that apply to such care and services under part B of title XVIII, and allowing Federally-qualified health centers to contract with specialty physicians to be paid at Federally-qualified health center payment rates for services furnished in a physician’s office), including such strategies as modified through such a model, improve access, outcomes, and patient satisfaction for such individuals and reduce emergency department utilization by such individuals. (D) Disproportionate share county defined In this paragraph, the term disproportionate share county .

Summary: Assessing Critical Care Efforts to Strengthen Services (ACCESS) Act of 2017 This bill amends title XI (General Provisions) of the Social Security Act to establish a Medicaid payment model demonstration project for recruiting and retaining physicians to serve low-income individuals residing in counties in which at least 35% of residents are enrolled in Medicaid. In evaluating such a test model, the Center for Medicare and Medicaid Innovation must assess: (1) the model's applicability to informing national strategies; and (2) the degree to which Medicaid payment strategies reduce emergency-department utilization and improve access, outcomes, and patient satisfaction.