Sustaining Excellence in Medicaid Act of 2019

Bill: 116-hr-3253
Sponsor: Rep. Dingell, Debbie [D-MI-12]
Introduced: 2019-06-13 in the House
Policy area: Health
Subjects: Administrative law and regulatory procedures
Child health
Congressional oversight
Criminal investigation, prosecution, interrogation
Department of Health and Human Services
Fraud offenses and financial crimes
Government studies and investigations
Health care costs and insurance
Health care quality
Health programs administration and funding
Health promotion and preventive care
Home and outpatient care
Long-term, rehabilitative, and terminal care
Marriage and family status
Medicaid
Mental health
Prescription drugs
State and local finance
State and local government operations

Summary:
action_date: 2019-06-13
text: 

Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019

 
This bill alters several Medicaid programs and funding mechanisms. Specifically, the bill 
 
 
makes appropriations through FY2024 for, and otherwise revises, the Money Follows the Person Rebalancing Demonstration Program; 
 
allows state Medicaid fraud control units to review complaints regarding patients who are in noninstitutional or other settings;
 
temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home and community-based services; 
 
temporarily extends the Medicaid demonstration program for certified community behavioral health clinics;
 
repeals the requirement, under the Medicaid Drug Rebate Program, that drug manufacturers include the prices of certain authorized generic drugs when determining the average manufacturer price (AMP) of brand-name drugs (also known as a &quot;blended AMP&quot;), and excludes manufacturers from the definition of &quot;wholesalers&quot; for purposes of rebate calculations; and
 
increases funding available to the Medicaid Improvement Fund beginning in FY2021. 


action_date: 2019-06-18
text: 

Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019

 
This bill alters several Medicaid programs and funding mechanisms. Specifically, the bill 
 
 
makes appropriations through FY2024 for, and otherwise revises, the Money Follows the Person Rebalancing Demonstration Program; 
 
allows state Medicaid fraud control units to review complaints regarding patients who are in noninstitutional or other settings;
 
temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home and community-based services; 
 
temporarily extends the Medicaid demonstration program for certified community behavioral health clinics;
 
repeals the requirement, under the Medicaid Drug Rebate Program, that drug manufacturers include the prices of certain authorized generic drugs when determining the average manufacturer price (AMP) of brand-name drugs (also known as a &quot;blended AMP&quot;), and excludes manufacturers from the definition of &quot;wholesalers&quot; for purposes of rebate calculations; and
 
increases funding available to the Medicaid Improvement Fund beginning in FY2021. 


action_date: 2019-07-25
text: 

Sustaining Excellence in Medicaid Act of 2019

 
This bill extends several health care programs and requirements and revises certain Medicare drug payment methodologies. 
 
(Sec. 2) The bill temporarily extends the Medicaid demonstration program for certified community behavioral health clinics.
 
(Sec. 3) The bill also temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home- and community-based services.
 
(Sec. 4) The bill increases appropriations for FY2019 for the Money Follows the Person Rebalancing Demonstration Program. (Under this program, the Centers for Medicare & Medicaid Services (CMS) may award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.) 
 
(Sec. 5) Additionally, the bill extends the Family-to-Family Health Information Centers Program, which is administered by the Health Resources and Services Administration. The program awards grants to family-run organizations to support the provision of information and peer support to families of children with special health care needs.
 
(Sec. 6) Finally, the bill provides statutory authority for a Medicare payment methodology that applies an add-on payment of up to 3% for new drugs or biologics (furnished on or after January 1, 2019) when the average sales price is unavailable and payment is instead based on the wholesale acquisition cost (WAC). (Effective January 1, 2019, the CMS reduced the WAC add-on payment in such situations from 6% to 3%.)

action_date: 2019-07-30
text: 

Sustaining Excellence in Medicaid Act of 2019

 
This bill extends several health care programs and requirements and revises certain Medicare drug payment methodologies. 
 
(Sec. 2) The bill temporarily extends the Medicaid demonstration program for certified community behavioral health clinics.
 
(Sec. 3) The bill also temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home- and community-based services.
 
(Sec. 4) The bill increases appropriations for FY2019 for the Money Follows the Person Rebalancing Demonstration Program. (Under this program, the Centers for Medicare & Medicaid Services (CMS) may award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.) 
 
(Sec. 5) Additionally, the bill extends the Family-to-Family Health Information Centers Program, which is administered by the Health Resources and Services Administration. The program awards grants to family-run organizations to support the provision of information and peer support to families of children with special health care needs.
 
(Sec. 6) Finally, the bill provides statutory authority for a Medicare payment methodology that applies an add-on payment of up to 3% for new drugs or biologics (furnished on or after January 1, 2019) when the average sales price is unavailable and payment is instead based on the wholesale acquisition cost (WAC). (Effective January 1, 2019, the CMS reduced the WAC add-on payment in such situations from 6% to 3%.)

action_date: 2019-08-06
text: 

Sustaining Excellence in Medicaid Act of 2019

 
This bill extends several health care programs and requirements and revises certain Medicare drug payment methodologies. 
 
(Sec. 2) The bill temporarily extends the Medicaid demonstration program for certified community behavioral health clinics.
 
(Sec. 3) The bill also temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home- and community-based services.
 
(Sec. 4) The bill increases appropriations for FY2019 for the Money Follows the Person Rebalancing Demonstration Program. (Under this program, the Centers for Medicare & Medicaid Services (CMS) may award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.) 
 
(Sec. 5) Additionally, the bill extends the Family-to-Family Health Information Centers Program, which is administered by the Health Resources and Services Administration. The program awards grants to family-run organizations to support the provision of information and peer support to families of children with special health care needs.
 
(Sec. 6) Finally, the bill provides statutory authority for a Medicare payment methodology that applies an add-on payment of up to 3% for new drugs or biologics (furnished on or after January 1, 2019) when the average sales price is unavailable and payment is instead based on the wholesale acquisition cost (WAC). (Effective January 1, 2019, the CMS reduced the WAC add-on payment in such situations from 6% to 3%.)


Legislative actions:
action_date: 2019-08-06
text: Became Public Law No: 116-39.
action_date: 2019-08-06
text: Became Public Law No: 116-39.
action_date: 2019-08-06
text: Signed by President.
action_date: 2019-08-06
text: Signed by President.
action_date: 2019-08-01
text: Presented to President.
action_date: 2019-08-01
text: Presented to President.
action_date: 2019-07-30
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2019-07-30
text: On motion that the House agree to the Senate amendment Agreed to without objection. (text: CR H7477-7478)
action_date: 2019-07-30
text: Resolving differences -- House actions: On motion that the House agree to the Senate amendment Agreed to without objection.(text: CR H7477-7478)
action_date: 2019-07-30
text: Ms. Norton asked unanimous consent to take from the Speaker's Table and agree to the Senate amendment. (consideration: CR H7477-7478)
action_date: 2019-07-25
text: Message on Senate action sent to the House.
action_date: 2019-07-25
text: Passed Senate with an amendment by Voice Vote.
action_date: 2019-07-25
text: Passed/agreed to in Senate: Passed Senate with an amendment by Voice Vote.
action_date: 2019-07-25
text: Measure laid before Senate by unanimous consent. (consideration: CR S5114)
action_date: 2019-06-19
text: Received in the Senate, read twice.
action_date: 2019-06-18
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2019-06-18
text: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 371 - 46 (Roll no. 333). (text: CR H4706-4707)
action_date: 2019-06-18
text: Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 371 - 46 (Roll no. 333).(text: CR H4706-4707)
action_date: 2019-06-18
text: Considered as unfinished business. (consideration: CR H4751)
action_date: 2019-06-18
text: At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
action_date: 2019-06-18
text: DEBATE - The House proceeded with forty minutes of debate on H.R. 3253.
action_date: 2019-06-18
text: Considered under suspension of the rules. (consideration: CR H4706-4710)
action_date: 2019-06-18
text: Mrs. Dingell moved to suspend the rules and pass the bill, as amended.
action_date: 2019-06-13
text: Referred to the House Committee on Energy and Commerce.
action_date: 2019-06-13
text: Introduced in House
action_date: 2019-06-13
text: Introduced in House

Enacted as: number: 116-39