Puerto Rico Integrity in Medicare Advantage Act

Bill: 116-hr-813
Sponsor: full_name: Resident Commissioner González-Colón, Jenniffer [R-PR-At Large]
Introduced: 2019-01-28
Policy area: Health
Subjects: Administrative remedies

Disaster relief and insurance

Health care costs and insurance

Health personnel

Insurance industry and regulation

Medicare

Puerto Rico
Latest action: action_date: 2019-01-29
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2019-01-28
action_desc: Introduced in House
text: <p><b>Puerto Rico Integrity in Medicare Advantage Act</b></p> <p>This bill temporarily establishes geographic adjustments for certain Medicare Advantage payment formulations, and specifies that a certain percentage of corresponding payment increases must be directed toward compensating providers in Puerto Rico.</p>

tv_txt: I 116th CONGRESS 1st Session H. R. 813 IN THE HOUSE OF REPRESENTATIVES January 28, 2019 Miss González-Colón of Puerto Rico (for herself, Mr. Serrano , Mr. Fitzpatrick , Mr. Soto , Ms. Velázquez , Mrs. Radewagen , and Mr. King of New York ) 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 provide for temporary stabilization of Medicare Advantage payments following Hurricane Maria.

1. Short title This Act may be cited as the Puerto Rico Integrity in Medicare Advantage Act . 2. Temporary stabilization of Medicare Advantage payments following Hurricane Maria (a) In general Section 1853(n) of the Social Security Act ( 42 U.S.C. 1395w–23(n) ) is amended— (1) in paragraph (1)(B), by striking subsequent year and inserting subsequent year, subject to paragraph (6), ; and (2) by adding at the end the following new paragraph: (6) Average geographic adjustment floor For each of 2020, 2021, and 2022, when calculating the adjusted average per capita cost under section 1876(a)(4) for the purposes of establishing the base payment amount specified in paragraph (2)(E), the average geographic adjustment shall not be less than 0.70 for any area. For purposes of the previous sentence, the Secretary may define the term average geographic adjustment by program instruction or otherwise. . (b) Ensuring payments flow to Puerto Rico providers and patients Section 1854(a)(6) of the Social Security Act ( 42 U.S.C. 1395w–24(a)(6) ) is amended by adding at the end the following new subparagraph: (C) Strengthening support to health care providers in Puerto Rico With respect to plans serving areas in Puerto Rico, of the increase in blended benchmark amount attributable to section 1853(n)(6), no less than 50 percent is directed toward provider compensation. .