118 HR 5380 IH: To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. U.S. House of Representatives 2023-09-08 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I118th CONGRESS1st SessionH. R. 5380IN THE HOUSE OF REPRESENTATIVESSeptember 8, 2023Mr. Sarbanes 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 concernedA BILLTo amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

1.

Increasing data transparency for supplemental benefits under Medicare Advantage

(a)

In general

Section 1857(e) of the Social Security Act (42 U.S.C. 1395w–27(e)) is amended by adding at the end the following new paragraph:(6)

Reporting of enrollee-level data on supplemental benefits

(A)

In general

Beginning with plan years beginning on or after January 1, 2027, a contract under this section with an MA organization shall require the organization to submit to the Secretary, for each MA plan offered by the organization, enrollee-level data on supplemental benefits (by item or service, or category of item or service, as determined appropriate by the Secretary, and national provider identifier), including eligibility for such benefits, the types of benefit categories offered, data on utilization of and payments for such benefits (including the total amount spent by the plan for each enrollee who utilized such benefits and the total out-of-pocket cost per utilization for each enrollee).(B)

Data access

(i)

In general

On the first Monday in October of each year (beginning with 2028), the Secretary shall make data submitted under subparagraph (A) available to individuals and entities for the purpose of conducting—(I)evaluations and other analysis to support the program under this title; and(II)other health care related research.(ii)

Public use data file

Not later than October 1 of each year (beginning with 2028), the Secretary shall make a public use data file containing the data submitted under subparagraph (A) available on the internet website of the Centers for Medicare & Medicaid Services.(iii)

Confidentiality

In making data available under this subparagraph, the Secretary shall have in place procedures to safeguard the privacy of any individually identifiable enrollee information..(b)

Rule of construction

Nothing in the amendments made by this section shall affect the collection of information as proposed pursuant to the notice entitled Agency Information Collection Activities: Proposed Collection; Comment Request, published in the Federal Register on March 14, 2023 (88 Fed. Reg. 15726).