Medicare Part B Improvement Act of 2017

This bill amends title XVIII (Medicare) of the Social Security Act to:

• establish a transitional Medicare payment system with respect to certain home infusion services;
• extend the Medicare Intravenous Immune Globulin demonstration project and provide for participants to be automatically reenrolled in the project;
• specify that, for purposes of determining the reasonableness and medical necessity of orthotics and prosthetics, documentation created by an orthotist or prosthetist shall be considered part of a beneficiary's medical record;
• allow renal dialysis facilities to be accredited for Medicare participation by an approved accreditation body;
• allow Medicare beneficiaries with end-stage renal disease (ESRD) to receive certain ESRD-related visits via telehealth;
• codify certain rules regarding signature requirements and holdover arrangements as they relate to prohibitions against physician self-referrals; and
• beginning in FY2021, reduce funding available to the Medicare Improvement Fund by an amount equal to the amount of projected expenditures attributable to specified provisions of the bill.

TITLE I--IMPROVEMENTS IN PROVISION OF HOME INFUSION THERAPY

(Sec. 101) This bill amends title XVIII (Medicare) of the Social Security Act to temporarily provide for transitional Medicare payment with respect to certain home infusion services furnished on or after January 1, 2019. Under current law, the Center for Medicare & Medicaid Services (CMS) is required to establish a permanent payment system with respect to such services furnished on or after January 1, 2021.

(Sec. 102) The bill extends the Medicare Intravenous Immune Globulin demonstration project through 2020, subject to the availability of funds. A Medicare beneficiary who is enrolled in the project on September 30, 2017, shall be automatically reenrolled, subject to an existing cap on project participants.

(Sec. 103)  Documentation created by an orthotist or prosthetist shall be considered part of a Medicare beneficiary's medical record for purposes of determining the reasonableness and medical necessity of orthotics and prosthetics.

TITLE II--IMPROVEMENTS IN DIALYSIS SERVICES

(Sec. 201) The bill allows renal dialysis facilities to be accredited by a CMS-approved accreditation body for participation in the Medicare program. The bill also establishes a  time frame with respect to initial surveys of renal dialysis facilities.

(Sec. 202) A Medicare beneficiary who has end-stage renal disease (ESRD) and is receiving home dialysis may choose to receive monthly ESRD-related visits via telehealth, provided that the beneficiary also receives face-to-face visits periodically. Specified facility fees and geographic requirements shall not apply with respect to the provision of such services via telehealth.

The Government Accountability Office must study and report to Congress on the further expansion of Medicare coverage of renal dialysis services furnished via telehealth.

TITLE III--IMPROVEMENTS IN APPLICATION OF STARK RULE

(Sec. 301) The bill codifies certain CMS rules regarding signature requirements and holdover arrangements as they relate to prohibitions against physician self-referrals.

(Sec. 302) The bill reduces annual funding available to the Medicare Improvement Fund beginning in FY2021.