Addressing Whole Health in Medicare Advantage Act

Bill: 118-hr-5746
Sponsor: full_name: Rep. Bilirakis, Gus M. [R-FL-12]
Introduced: 2023-09-27
Policy area: Health
Subjects: Health care coverage and access

Medicare
Latest action: action_date: 2024-12-17
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2023-09-27
action_desc: Introduced in House
text: <p><b>Addressing Whole Health in Medicare Advantage Act</b></p> <p>This bill allows Medicare Advantage plans to offer certain supplemental benefits that are currently only available to chronically ill enrollees to enrollees with low-income or who meet other criteria, such as socioeconomic risk factors.</p>

tv_txt: I 118th CONGRESS 1st Session H. R. 5746 IN THE HOUSE OF REPRESENTATIVES September 27, 2023 Mr. Bilirakis (for himself and Mr. Blumenauer ) 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 expand the availability of supplemental benefits to certain Medicare Advantage enrollees.

1. Short title This Act may be cited as the Addressing Whole Health in Medicare Advantage Act . 2. Expanding the availability of supplemental benefits to certain Medicare Advantage enrollees (a) In general Section 1852(a)(3)(D) of the Social Security Act ( 42 U.S.C. 1395w–22(a)(3)(D) ) is amended— (1) in the header, by striking chronically ill and inserting certain ; (2) in clauses (i) and (ii), by striking chronically ill each place such term appears and inserting specified in each such place; and (3) in clause (iii), by amending such clause to read as follows: (iii) Specified enrollee defined In this subparagraph, the term specified enrollee means an enrollee in an MA plan that— (I) the Secretary determines— (aa) has one or more comorbid and medically complex chronic conditions that is life threatening or significantly limits the overall health or function of the enrollee; (bb) has a high risk of hospitalization or other adverse health outcomes; or (cc) requires intensive care coordination; (II) is a low-income enrollee (as specified by the Secretary); or (III) meets any other criterion determined appropriate by the Secretary, such as criteria relating to social and socioeconomic risk. . (b) Effective date The amendments made by subsection (a) shall apply with respect to plan years beginning on or after January 1, 2025.