[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5746 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 5746

     To amend title XVIII of the Social Security Act to expand the 
  availability of supplemental benefits to certain Medicare Advantage 
                               enrollees.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 27, 2023

Mr. 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 
                               concerned

_______________________________________________________________________

                                 A BILL


 
     To amend title XVIII of the Social Security Act to expand the 
  availability of supplemental benefits to certain Medicare Advantage 
                               enrollees.

    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 ``Addressing Whole Health in Medicare 
Advantage Act''.

SEC. 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.
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