3.0.0 2758 2023-01-11T13:18:52Z 2023-01-11T13:18:52Z House H HR 2009-06-08 111 hsif00 Energy and Commerce Committee House Standing hsif14 Health Subcommittee Referred to 2009-06-09T18:25:08Z Referred to 2009-06-08T16:31:51Z hswm00 Ways and Means Committee House Standing Referred to 2009-06-08T16:31:52Z Medicare Specialty Care Improvement and Protection Act of 2009 111 1307 S 2009-06-19 Read twice and referred to the Committee on Finance. Related bill CRS 2009-06-09 hsif14 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health. Committee 2009-06-08 Referred to House Ways and Means IntroReferral H11100 2 House floor actions hswm00 Ways and Means Committee 2009-06-08 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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. IntroReferral H11100-A 9 Library of Congress 2009-06-08 Referred to House Energy and Commerce IntroReferral H11100 2 House floor actions hsif00 Energy and Commerce Committee 2009-06-08 Introduced in House IntroReferral Intro-H 9 Library of Congress 2009-06-08 Introduced in House IntroReferral 1000 9 Library of Congress K000188 Rep. Kind, Ron [D-WI-3] RON KIND D WI 3 N B001230 Rep. Baldwin, Tammy [D-WI-2] Tammy Baldwin D WI 2 2009-06-08 True Health Department of Health and Human Services Disability and paralysis Executive agency funding and structure Government studies and investigations Health care quality Long-term, rehabilitative, and terminal care Medicaid Medicare Health 00 2009-06-08 Introduced in House 2009-07-15T20:11:39Z Medicare Specialty Care Improvement and Protection Act of 2009 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to extend through December 31, 2013, the authority to restrict enrollment for specialized Medicare Advantage (MA) plans for special needs individuals (SNPs).

Extends such authority through December 31, 2015, in the case of a SNP designated as a Fully Integrated Dual Eligible Special Needs Plan..

Directs the Secretary of Health and Human Services (HHS) to evaluate the MA and the health status risk adjustment payment mechanisms in order to resolve plan payment inequities relative to Medicare fee-for-service payments for high-risk, high cost beneficiaries. Directs the Secretary, using the results of the evaluation, to refine the risk adjustment payment mechanism for such beneficiaries.

Requires the Secretary to provide bonus payments to account for added SNP costs associated with additional benefit, care management, reporting, and other requirements established by Congress and the Secretary in excess of other MA plans.

Requires the Secretary to take into account specified factors, including dual eligibility (for both Medicare and SSA title XIX [Medicaid] benefits) and geographic cost differences, with respect to the bid structure for SNPs.

Requires the Secretary to have in place a process under which the Secretary designates dual eligible SNPs as Fully Integrated Dual Eligible Special Needs Plans for the purpose of advancing fully integrated Medicare and Medicaid benefits and services for dual eligible beneficiaries, including state-designated Dual subsets.

Directs the Secretary to establish or designate an Office on Medicare/Medicaid Integration.

Requires the Medicaid plan to provide that an individual who has attained age 65, and has been determined for 12 consecutive months to be a full-benefit dual eligible individual, to be presumed to remain eligible for benefits under the plan without any need for further redetermination or recertification.

]]> Medicare Specialty Care Improvement and Protection Act of 2009 Display Title Medicare Specialty Care Improvement and Protection Act of 2009 Official Title as Introduced To amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes. Introduced in House IH Short Titles as Introduced Medicare Specialty Care Improvement and Protection Act of 2009 Introduced in House 2009-06-08T04:00:00Z https://www.govinfo.gov/content/pkg/BILLS-111hr2758ih/xml/BILLS-111hr2758ih.xml 2009-06-09 Referred to the Subcommittee on Health. 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. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.