Ask AI
Bill114th CongressFiled May 22, 2015Health
H.R. 2570

Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015

Bill journey · stage 2 of 5

Under committee review

Filed
Comm.
Floor
Both
Law

What it doesSummary passed house amended (Jun 17, 2015)

Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015

(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act (SSAct) with respect to criteria for qualifying as a meaningful user of electronic health records (meaningful EHR user). For any payment year after 2015 any patient encounter of an eligible professional occurring at an eligible ambulatory surgical center shall not be treated as one in determining whether an eligible professional qualifies as a meaningful EHR user.

(Sec. 3) HHS shall establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage (MA) plans offered by MA organizations under Medicare part C.

"Value-based insurance design methodology" is one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by HHS.

HHS may expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met.

(Sec. 4) Payment amounts are prescribed for infusion drugs and biologicals furnished through durable medical equipment (DME) on or after January 1, 2017.

(Sec. 5) It is the sense of Congress that HHS:

  • has incorrectly interpreted the determination of blended benchmark amounts as prohibiting the provision of any Medicare quality incentive payments with respect to MA plans that exceed the payment benchmark cap for the area served by those plans; and
  • should immediately apply quality incentive payments with respect to such MA plans without regard to limits.

(Sec. 6) $220 million shall be available to the Medicare Improvement Fund during and after FY2020.

(Sec. 7) DME competitive acquisition programs shall not cover infusion drugs and biologicals.

What just happenedJun 18, 2015

Received in the Senate and Read twice and referred to the Committee on Finance.

Who’s behind it

Rep. Black, Diane [R-TN-6](R-TN)Sponsor
3 cosponsors2 D1 R
Read on Congress.gov
3cosponsors3committees15actions2related bills8subjects
  1. Jun 18, 2015IntroReferral

    Received in the Senate and Read twice and referred to the Committee on Finance.

    Finance Committee
  2. Jun 17, 2015FloorH38800

    The title of the measure was amended. Agreed to without objection.

  3. Jun 17, 2015FloorH38310

    Motion to reconsider laid on the table Agreed to without objection.

  4. Jun 17, 2015FloorH37300

    On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4479-4480)

  5. Jun 17, 2015Floor8000

    Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.(text: CR H4479-4480)

  6. Jun 17, 2015FloorH8D000

    DEBATE - The House proceeded with forty minutes of debate on H.R. 2570.

  7. Jun 17, 2015FloorH30000

    Considered under suspension of the rules. (consideration: CR H4479-4481)

  8. Jun 17, 2015FloorH30300

    Mr. Brady (TX) moved to suspend the rules and pass the bill, as amended.

  9. Jun 3, 2015Committee

    Referred to the Subcommittee on Health.

    Health Subcommittee
  10. May 29, 2015Committee

    Referred to the Subcommittee on Health.

    Health Subcommittee
  11. May 22, 2015IntroReferralH11100

    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.

    Energy and Commerce Committee
  12. May 22, 2015IntroReferralH11100-A

    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.

  13. May 22, 2015IntroReferralH11100

    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.

    Ways and Means Committee
  14. May 22, 2015IntroReferralIntro-H

    Introduced in House

  15. May 22, 2015IntroReferral1000

    Introduced in House

Passed House amendedJun 17, 201536

Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015

(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act (SSAct) with respect to criteria for qualifying as a meaningful user of electronic health records (meaningful EHR user). For any payment year after 2015 any patient encounter of an eligible professional occurring at an eligible ambulatory surgical center shall not be treated as one in determining whether an eligible professional qualifies as a meaningful EHR user.

(Sec. 3) HHS shall establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage (MA) plans offered by MA organizations under Medicare part C.

"Value-based insurance design methodology" is one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by HHS.

HHS may expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met.

(Sec. 4) Payment amounts are prescribed for infusion drugs and biologicals furnished through durable medical equipment (DME) on or after January 1, 2017.

(Sec. 5) It is the sense of Congress that HHS:

  • has incorrectly interpreted the determination of blended benchmark amounts as prohibiting the provision of any Medicare quality incentive payments with respect to MA plans that exceed the payment benchmark cap for the area served by those plans; and
  • should immediately apply quality incentive payments with respect to such MA plans without regard to limits.

(Sec. 6) $220 million shall be available to the Medicare Improvement Fund during and after FY2020.

(Sec. 7) DME competitive acquisition programs shall not cover infusion drugs and biologicals.

Introduced in HouseMay 22, 2015

Value Based Insurance Design for Better Care Act of 2015 or the VBID for Better Care Act of 2015

Directs the Department of Health and Human Services (HHS) to establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage plans offered by Medicare Advantage organizations under part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act.

Defines "value-based insurance design methodology" as one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by the Secretary.

Authorizes HHS to expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met.

Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015 — Informed