Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015

Hozzl · 2023-01-11T13:31:02Z

Explore the details of House Bill 2570 Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015 currently in Congress. Get insights into its purpose, current status, sponsors, and potential impact on Health. Stay informed on legislative developments.

1/11/2023, 1:31 PM

Congressional Summary of HR 2570

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.

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Current Status of Bill HR 2570

Bill HR 2570 is currently in the status of Bill Introduced since May 22, 2015. Bill HR 2570 was introduced during Congress 114 and was introduced to the House on May 22, 2015. Bill HR 2570's most recent activity was Received in the Senate and Read twice and referred to the Committee on Finance. as of June 18, 2015

Bipartisan Support of Bill HR 2570

Total Number of Sponsors

Democrat Sponsors

Republican Sponsors

Unaffiliated Sponsors

Total Number of Cosponsors

Democrat Cosponsors

Republican Cosponsors

Unaffiliated Cosponsors

Policy Area and Potential Impact of Bill HR 2570

Primary Policy Focus

Health

Potential Impact Areas

Health care costs and insuranceHealth care qualityHealth information and medical recordsHealth technology, devices, suppliesHome and outpatient careMedicarePrescription drugsSurgery and anesthesia

Alternate Title(s) of Bill HR 2570

Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015To establish a demonstration program requiring the utilization of Value-Based Insurance Design to demonstrate that reducing the copayments or coinsurance charged to Medicare beneficiaries for selected high-value prescription medications and clinical services can increase their utilization and ultimately improve clinical outcomes and lower health care expenditures.Value Based Insurance Design for Better Care Act of 2015VBID for Better Care Act of 2015Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015To amend title XVIII of the Social Security Act with respect to the treatment of patient encounters in ambulatory surgical centers in determining meaningful EHR use, establish a demonstration program requiring the utilization of Value-Based Insurance Design to demonstrate that reducing the copayments or coinsurance charged to Medicare beneficiaries for selected high-value prescription medications and clinical services can increase their utilization and ultimately improve clinical outcomes and lower health care expenditures, and for other purposes.

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