Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016

Bill: 114-hr-5942
Sponsor: Rep. Young, Todd [R-IN-9]
Introduced: 2016-09-07 in the House
Policy area: Health
Subjects: Digestive and metabolic diseases
Government information and archives
Health care costs and insurance
Health care coverage and access
Health care quality
Health information and medical records
Health promotion and preventive care
Hospital care
Medicaid
Medicare
Organ and tissue donation and transplantation
Prescription drugs

Summary:
action_date: 2016-09-07
text: 

Dialysis PATIENTS Demonstration Act of 2016 or the Dialysis Patient Access to Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016

 
This bill amends title XVIII (Medicare) of the Social Security Act to establish a demonstration program for the provision of integrated care to Medicare beneficiaries with end-stage renal disease (ESRD). 
 
Under the voluntary program, eligible participating providers may form organizations to offer ESRD integrated care models and serve as medical homes for program-eligible beneficiaries. Such a model: (1) shall cover medical and hospital services, other than hospice care, under Medicare; (2) must include benefits for transition into palliative care; and (3) may cover prescription drug benefits. An organization must offer at least one open network model but may also offer one or more preferred network models.
 
An organization shall return savings achieved under the models to program-eligible beneficiaries.
 
A beneficiary shall have the opportunity to: (1) opt out of the program, (2) make an assignment change into an open network model offered by a different organization, or (3) elect a preferred network model.
 
The bill establishes requirements regarding: (1) benefits for program-eligible beneficiaries who are also eligible for Medicaid benefits, (2) program quality and reporting, (2) ESRD integrated care strategy, (3) program operation and scope, (4) beneficiary notification, and (5) payment.


Legislative actions:
action_date: 2016-09-08
text: Ordered to be Reported (Amended) by Voice Vote.
action_date: 2016-09-08
text: Committee Consideration and Mark-up Session Held.
action_date: 2016-09-07
text: Referred to the Subcommittee on Health.
action_date: 2016-09-07
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: 2016-09-07
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: 2016-09-07
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: 2016-09-07
text: Introduced in House
action_date: 2016-09-07
text: Introduced in House