117 HR 7997 IH: Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act U.S. House of Representatives 2022-06-09 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.

I117th CONGRESS2d SessionH. R. 7997IN THE HOUSE OF REPRESENTATIVESJune 9, 2022Miss González-Colón (for herself, Mr. Soto, Ms. Velázquez, Ms. Salazar, Mr. Crist, Mr. Fitzpatrick, Mr. Bacon, Mr. Espaillat, and Mrs. Radewagen) introduced the following bill; which was 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 concernedA BILLTo amend title XVIII of the Social Security Act to establish a floor in Medicare Advantage benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions.

1.

Short title

This Act may be cited as the Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act.

2.

Addressing disparities in Medicare Advantage benchmark levels based on penetration

(a)

In general

Section 1853(n) of the Social Security Act (42 U.S.C. 1395w–23(n)) is amended—(1)in paragraph (1)(B), by striking subsequent year and inserting subsequent year, subject to paragraph (6),; and(2)by adding at the end the following new paragraph:(6)

Average geographic adjustment floor

For 2024 and subsequent years, when calculating the adjusted average per capita cost under section 1876(a)(4) for the purposes of establishing the base payment amount specified in paragraph (2)(E), the average geographic adjustment shall not be less than 0.70 for any area. For the purposes of the previous sentence, the Secretary may define the term average geographic adjustment under subparagraph (A) by program instruction or otherwise..(b)

Ensuring plan payments flow to providers and patients

Section 1854(a)(6) of the Social Security Act (42 U.S.C. 1395w–24(a)(6)) is amended by adding at the end the following new subparagraph:(C)

Ensuring increased payments support care

With respect to the increase in blended benchmark amount attributable to the application of section 1853(n)(6), no less than 50 percent shall be directed toward payment for basic benefits as defined in section 1852(a)(1)(B)..

3.

Expanding the Medicare Savings Program to the territories

Section 1905(p)(4) of the Social Security Act (42 U.S.C. 1396d(p)(4)) is amended by inserting for fiscal years through 2022 after Columbia).