Incentivizing Shared Risk in Medicare Advantage Act

Bill: 115-hr-7247
Sponsor: full_name: Rep. Brady, Kevin [R-TX-8]
Introduced: 2018-12-11
Policy area: Health
Subjects: Health care costs and insurance

Health programs administration and funding

Medicare

Public contracts and procurement
Latest action: action_date: 2018-12-17
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2018-12-11
action_desc: Introduced in House
text: <p><b>Incentivizing Shared Risk in Medicare Advantage Act</b></p> <p>This bill specifies that Medicare Advantage organizations may waive prior authorization requirements for items and services, including with respect to providers and suppliers that are part of risk-sharing or value-based payment arrangements.</p>

tv_txt: I 115th CONGRESS 2d Session H. R. 7247 IN THE HOUSE OF REPRESENTATIVES December 11, 2018 Mr. Brady of Texas (for himself and Mr. Shimkus ) introduced the following bill; which was 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 A BILL To amend title XVIII of the Social Security Act to clarify the authority of MA organizations to provide waivers from Medicare Advantage plans’ prior authorization requirements.

1. Short title This Act may be cited as the Incentivizing Shared Risk in Medicare Advantage Act . 2. Authority of MA organizations to provide waivers from Medicare Advantage plans’ prior authorization requirements Section 1857(e) of the Social Security Act ( 42 U.S.C. 1395w–27(e) ) is amended by adding at the end the following new paragraph: (5) Authority to provide waivers from plan prior authorization requirements In the case of an MA organization with a contract under this section that applies a prior authorization requirement with respect to any item or service covered under the Medicare Advantage plan offered by such organization, such organization may provide for a waiver from such requirement for any provider of services or supplier, as specified by the organization, furnishing such an item or service, including a provider of services or supplier that participates in a risk-sharing arrangement or value-based payment arrangement, as such terms are defined by the organization. .