Securing Care for Seniors Act of 2015

Bill: 114-hr-2579
Sponsor: Rep. Black, Diane [R-TN-6]
Introduced: 2015-05-29 in the House
Policy area: Health
Subjects: Accounting and auditing
Digestive and metabolic diseases
Government studies and investigations
Health care costs and insurance
Health information and medical records
Medicaid
Medical tests and diagnostic methods
Medicare

Summary:
action_date: 2015-05-29
text: 

Securing Care for Seniors Act of 2015 

 
This bill amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSAct) to direct the Department of Health and Human Services (HHS) (in effect, the Centers for Medicare & Medicaid Services [CMS]) to revise for 2017, and periodically afterwards, the system for risk adjustments to payments to Medicare + Choice organizations so that an individual's risk score takes into account the number of chronic conditions with which the individual has been diagnosed.
 
HHS must, including an actuarial opinion of the CMS Chief Actuary, evaluate the impacts of:
 
 
including two years of data to compare the models used to determine the risk scores for 2013 and 2014, 
removing the diagnosis codes related to chronic kidney disease in the 2014 risk adjustment model, and 
including 10% of encounter data in computing payment for 2016 and CMS readiness to incorporate encounter data in risk scores. 
 
 
HHS shall also analyze the best practices of MedicareAdvantage (MA) plans to slow disease progression related to chronic kidney disease.
 
HHS shall then, if appropriate, make revisions to the risk adjustment system, based on such an evaluation or analysis, to better reflect and appropriately weight for the population served.
 
Congress declares that the MA star rating system lacks proper accounting for the socioeconomic status of plan enrollees and the extent to which those plans serve individuals also eligible for medical assistance under SSAct title XIX (Medicaid).

action_date: 2015-06-16
text: 

Securing Care for Seniors Act of 2015

 
(Sec. 2) This bill amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSAct) to direct the Department of Health and Human Services (HHS) (in effect, the Centers for Medicare & Medicaid Services [CMS]) to revise for 2017, and periodically afterwards, the system for risk adjustments to payments to Medicare+Choice organizations so that an individual's risk score takes into account the number of chronic conditions with which the individual has been diagnosed.
 
HHS must, including an actuarial opinion of the CMS Chief Actuary, evaluate the impacts of:
 
 
including two years of data to compare the models used to determine the risk scores for 2013 and 2014,
 
removing the diagnosis codes related to chronic kidney disease in the 2014 risk adjustment model, and
 
including 10% of encounter data in computing payment for 2016 and CMS readiness to incorporate encounter data in risk scores. 
 
 
HHS shall also analyze the best practices of MedicareAdvantage (MA) plans to slow disease progression related to chronic kidney disease.
 
HHS shall then, if appropriate, make revisions to the risk adjustment system, based on such an evaluation or analysis, to better reflect and appropriately weight for the population served.
 
(Sec. 3) Congress declares that the MA star rating system lacks proper accounting for the socioeconomic status of plan enrollees and the extent to which those plans serve individuals also eligible for medical assistance under SSAct title XIX (Medicaid).


Legislative actions:
action_date: 2015-06-16
text: Placed on the Union Calendar, Calendar No. 116.
action_date: 2015-06-16
text: Committee on Energy and Commerce discharged.
action_date: 2015-06-16
text: Committee on Energy and Commerce discharged.
action_date: 2015-06-16
text: Reported (Amended) by the Committee on Ways and Means. H. Rept. 114-160, Part I.
action_date: 2015-06-16
text: Reported (Amended) by the Committee on Ways and Means. H. Rept. 114-160, Part I.
action_date: 2015-06-05
text: Referred to the Subcommittee on Health.
action_date: 2015-06-03
text: Referred to the Subcommittee on Health.
action_date: 2015-06-02
text: Ordered to be Reported (Amended) by Voice Vote.
action_date: 2015-06-02
text: Committee Consideration and Mark-up Session Held.
action_date: 2015-05-29
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: 2015-05-29
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: 2015-05-29
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: 2015-05-29
text: Introduced in House
action_date: 2015-05-29
text: Introduced in House