Title: Puerto Rico Integrity in Medicare Advantage Act
Policy area: Health

Summary:
Puerto Rico Integrity in Medicare Advantage Act
This bill temporarily establishes geographic adjustments for certain Medicare Advantage payment formulations, and specifies that a certain percentage of corresponding payment increases must be directed toward compensating providers in Puerto Rico.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 813 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 813

    To amend title XVIII of the Social Security Act to provide for 
   temporary stabilization of Medicare Advantage payments following 
                            Hurricane Maria.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 28, 2019

   Miss Gonzalez-Colon of Puerto Rico (for herself, Mr. Serrano, Mr. 
 Fitzpatrick, Mr. Soto, Ms. Velazquez, Mrs. Radewagen, and Mr. King of 
  New York) 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 amend title XVIII of the Social Security Act to provide for 
   temporary stabilization of Medicare Advantage payments following 
                            Hurricane Maria.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Puerto Rico Integrity in Medicare 
Advantage Act''.

SEC. 2. TEMPORARY STABILIZATION OF MEDICARE ADVANTAGE PAYMENTS 
              FOLLOWING HURRICANE MARIA.

    (a) In General.--Section 1853(n) of the Social Security Act (42 
U.S.C. 1395w-23(n)) is amended--
            (1) in paragraph (1)(B), by striking ``subsequent year'' 
        and inserting ``subsequent year, subject to paragraph (6),''; 
        and
            (2) by adding at the end the following new paragraph:
            ``(6) Average geographic adjustment floor.--For each of 
        2020, 2021, and 2022, when calculating the adjusted average per 
        capita cost under section 1876(a)(4) for the purposes of 
        establishing the base payment amount specified in paragraph 
        (2)(E), the average geographic adjustment shall not be less 
        than 0.70 for any area. For purposes of the previous sentence, 
        the Secretary may define the term `average geographic 
        adjustment' by program instruction or otherwise.''.
    (b) Ensuring Payments Flow to Puerto Rico Providers and Patients.--
Section 1854(a)(6) of the Social Security Act (42 U.S.C. 1395w-
24(a)(6)) is amended by adding at the end the following new 
subparagraph:
                    ``(C) Strengthening support to health care 
                providers in puerto rico.--With respect to plans 
                serving areas in Puerto Rico, of the increase in 
                blended benchmark amount attributable to section 
                1853(n)(6), no less than 50 percent is directed toward 
                provider compensation.''.
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