118 HR 5746 IH: Addressing Whole Health in Medicare Advantage Act U.S. House of Representatives 2023-09-27 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. 5746IN THE HOUSE OF REPRESENTATIVESSeptember 27, 2023Mr. 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 concernedA BILLTo 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.