[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7247 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 7247

    To amend title XVIII of the Social Security Act to clarify the 
    authority of MA organizations to provide waivers from Medicare 
           Advantage plans' prior authorization requirements.


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                    IN THE HOUSE OF REPRESENTATIVES

                           December 11, 2018

    Mr. Brady of Texas (for himself and Mr. Shimkus) 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 concerned

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                                 A BILL


 
    To amend title XVIII of the Social Security Act to clarify the 
    authority of MA organizations to provide waivers from Medicare 
           Advantage plans' prior authorization requirements.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Incentivizing Shared Risk in 
Medicare Advantage Act''.

SEC. 2. AUTHORITY OF MA ORGANIZATIONS TO PROVIDE WAIVERS FROM MEDICARE 
              ADVANTAGE PLANS' PRIOR AUTHORIZATION REQUIREMENTS.

    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:
            ``(5) Authority to provide waivers from plan prior 
        authorization requirements.--In the case of an MA organization 
        with a contract under this section that applies a prior 
        authorization requirement with respect to any item or service 
        covered under the Medicare Advantage plan offered by such 
        organization, such organization may provide for a waiver from 
        such requirement for any provider of services or supplier, as 
        specified by the organization, furnishing such an item or 
        service, including a provider of services or supplier that 
        participates in a risk-sharing arrangement or value-based 
        payment arrangement, as such terms are defined by the 
        organization.''.
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