Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015

Bill: 114-hr-2570
Sponsor: Rep. Black, Diane [R-TN-6]
Introduced: 2015-05-22 in the House
Policy area: Health
Subjects: Health care costs and insurance
Health care quality
Health information and medical records
Health technology, devices, supplies
Home and outpatient care
Medicare
Prescription drugs
Surgery and anesthesia

Summary:
action_date: 2015-05-22
text: 

Value Based Insurance Design for Better Care Act of 2015 or the VBID for Better Care Act of 2015

 
Directs the Department of Health and Human Services (HHS) to establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage plans offered by Medicare Advantage organizations under part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act.
 
Defines "value-based insurance design methodology" as one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by the Secretary.
 
Authorizes HHS to expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met.

action_date: 2015-06-17
text: 

Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015

 
(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act (SSAct) with respect to criteria for qualifying as a meaningful user of electronic health records (meaningful EHR user). For any payment year after 2015 any patient encounter of an eligible professional occurring at an eligible ambulatory surgical center shall not be treated as one in determining whether an eligible professional qualifies as a meaningful EHR user.
 
(Sec. 3) HHS shall establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage (MA) plans offered by MA organizations under Medicare part C.
 
&quot;Value-based insurance design methodology" is one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by HHS.
 
 HHS may expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met.
 
(Sec. 4) Payment amounts are prescribed for infusion drugs and biologicals furnished through durable medical equipment (DME) on or after January 1, 2017.
 
(Sec. 5) It is the sense of Congress that HHS:
 
 
has incorrectly interpreted the determination of blended benchmark amounts as prohibiting the provision of any Medicare quality incentive payments with respect to MA plans that exceed the payment benchmark cap for the area served by those plans; and
 
should immediately apply quality incentive payments with respect to such MA plans without regard to limits.
 
 
(Sec. 6) $220 million shall be available to the Medicare Improvement Fund during and after FY2020.
 
(Sec. 7) DME competitive acquisition programs shall not cover infusion drugs and biologicals.


Legislative actions:
action_date: 2015-06-18
text: Received in the Senate and Read twice and referred to the Committee on Finance.
action_date: 2015-06-17
text: The title of the measure was amended. Agreed to without objection.
action_date: 2015-06-17
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2015-06-17
text: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4479-4480)
action_date: 2015-06-17
text: Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.(text: CR H4479-4480)
action_date: 2015-06-17
text: DEBATE - The House proceeded with forty minutes of debate on H.R. 2570.
action_date: 2015-06-17
text: Considered under suspension of the rules. (consideration: CR H4479-4481)
action_date: 2015-06-17
text: Mr. Brady (TX) moved to suspend the rules and pass the bill, as amended.
action_date: 2015-06-03
text: Referred to the Subcommittee on Health.
action_date: 2015-05-29
text: Referred to the Subcommittee on Health.
action_date: 2015-05-22
text: 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.
action_date: 2015-05-22
text: 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.
action_date: 2015-05-22
text: 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.
action_date: 2015-05-22
text: Introduced in House
action_date: 2015-05-22
text: Introduced in House