Medicare and Medicaid Improvements and Adjustments Act of 2015

Bill: 114-hr-4273
Sponsor: Rep. Green, Gene [D-TX-29]
Introduced: 2015-12-16 in the House
Policy area: Health
Subjects: Cancer
Civil actions and liability
Congressional oversight
Drug therapy
Fraud offenses and financial crimes
Government studies and investigations
Health facilities and institutions
Health information and medical records
Health personnel
Health programs administration and funding
Health technology, devices, supplies
Home and outpatient care
Hospital care
Long-term, rehabilitative, and terminal care
Medicaid
Medicare
Public contracts and procurement
Radiation
Surgery and anesthesia

Summary:
action_date: 2015-12-16
text: 

Medicare and Medicaid Improvements and Adjustments Act of 2015

 
This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify payment rules and other provisions related to the Medicare and Medicaid programs.
 
The bill includes off-campus outpatient department (OPD) services in Medicare's prospective payment system (in which predetermined amounts form the basis of payment) with respect to departments that are under development.
 
The existing Medicare payment adjustment for cancer hospitals shall apply to off-campus OPDs.
 
The bill temporarily prohibits specified Medicare payment adjustments related to competitive acquisition programs for certain wheelchair accessories.
 
In addition, the bill modifies provisions related to: (1) reimbursement under Medicare for certain drugs furnished through durable medical equipment (DME), (2) Medicare payment rules for certain radiation therapy services, and (3) the treatment of Medicaid supplemental needs trusts.
 
The bill expands criminal penalties and civil monetary penalties for certain acts involving federal health care programs.
 
With respect to negative Medicare payment adjustments for physicians and hospitals that fail to comply with certain requirements related to electronic health records (EHR), the bill authorizes a temporary blanket exception.
 
A patient encounter occurring at an ambulatory surgical center shall not be used to determine whether an eligible professional qualifies as a meaningful EHR user. This prohibition applies until a specified period has passed following a determination by the Department of Health and Human Services that certified EHR technology is applicable to that setting.
 
Current law limits state reimbursement for DME under Medicaid to Medicare payment rates beginning January 1, 2019. The bill accelerates this limitation such that it begins October 1, 2018. 


Legislative actions:
action_date: 2015-12-18
text: Referred to the Subcommittee on Health.
action_date: 2015-12-16
text: Referred to the Subcommittee on Health.
action_date: 2015-12-16
text: 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.
action_date: 2015-12-16
text: 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.
action_date: 2015-12-16
text: 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.
action_date: 2015-12-16
text: Introduced in House
action_date: 2015-12-16
text: Introduced in House