Rural ACO Improvement Act

Bill: 116-s-2648
Sponsor: full_name: Sen. Cortez Masto, Catherine [D-NV]
Introduced: 2019-10-21
Policy area: Health
Subjects: Health care costs and insurance

Health care quality

Health programs administration and funding

Medicare

Performance measurement
Latest action: action_date: 2019-10-21
text: Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2019-10-21
action_desc: Introduced in Senate
text: <p><b>Rural ACO Improvement Act</b></p> <p>This bill requires the Centers for Medicare &amp; Medicaid Services (CMS) to exclude certain components from a methodology used under the Medicare Shared Savings Program. The program enables accountable care organizations (ACOs) to receive payments for savings stemming from care coordination and management. </p> <p>Specifically, the bill requires the CMS to exclude an ACO's assigned Medicare fee-for-service beneficiaries from certain regional adjustments to the ACO's benchmark for savings determinations, and to otherwise ensure that an ACO is not in a less favorable financial position due to its share of assigned beneficiaries in the region. </p>

tv_txt: II 116th CONGRESS 1st Session S. 2648 IN THE SENATE OF THE UNITED STATES October 21, 2019 Ms. Cortez Masto (for herself and Mr. Roberts ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program.

1. Short title This Act may be cited as the Rural ACO Improvement Act . 2. Exclusion of Medicare fee-for-service beneficiaries assigned to an ACO from aspects of other payment models in certain circumstances including determination of regional adjustments Section 1899(i)(3) of the Social Security Act ( 42 U.S.C. 1395jjj(i)(3) ) is amended— (1) in subparagraph (A), by striking subparagraph (B) and inserting subparagraphs (B) and (C) ; and (2) by adding at the end the following new subparagraph: (C) Exclusion of assigned beneficiaries in certain circumstances including determination of regional adjustments For performance periods beginning on or after July 1, 2019, in determining any shared savings for any ACO under a model described in this paragraph, the Secretary shall— (i) remove Medicare fee-for-service beneficiaries who are assigned to that ACO from the methodology for calculating regional expenditures used to establish, update, and adjust the benchmark expenditures; and (ii) otherwise ensure that no such ACO is in a less favorable financial position due to differences between the share of Medicare fee-for-service beneficiaries assigned to the ACO of all such beneficiaries in the counties an ACO operates in compared to the share of such beneficiaries assigned to other ACOs. .