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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-KEL23A09-9S0-RK-VT1"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>118 S3573 IS: Medicare Advantage Supplemental Benefits Transparency Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2024-01-10</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>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.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>2d Session</session><legis-num>S. 3573</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20240110">January 10, 2024</action-date><action-desc><sponsor name-id="S327">Mr. Warner</sponsor> (for himself and <cosponsor name-id="S396">Mrs. Blackburn</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Medicare Advantage Supplemental Benefits Transparency Act</short-title></quote>.</text></section><section id="HAA06FE2DD09146B590A85955CEF44F98" section-type="subsequent-section"><enum>2.</enum><header>Increasing data transparency for supplemental benefits under Medicare Advantage</header><subsection commented="no" display-inline="no-display-inline" id="H7D4BC08F24BD43A991E7592EACEE956C"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1857(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-27">42 U.S.C. 1395w–27(e)</external-xref>) is amended by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H1C712C07EA02407B8EF69B706E0BE8AD"><paragraph id="H4FBD0E7E8724489C9A49BE7FC4A0B6E1"><enum>(6)</enum><header>Reporting of enrollee-level data on supplemental benefits</header><subparagraph commented="no" display-inline="no-display-inline" id="HD5D39028DA6149679375821D34CB0D09"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Beginning with plan years beginning on or after January 1, 2027, a contract under this section with an MA organization shall require the organization to submit to the Secretary, for each MA plan offered by the organization, enrollee-level data on supplemental benefits (by item or service, or category of item or service, as determined appropriate by the Secretary, and national provider identifier, if available), including eligibility requirements for such benefits, the benefit category applicable with respect to each such benefit, and data on utilization of and payments for such benefits (including the total amount spent by the plan for each enrollee who utilized such benefits and the total out-of-pocket cost per utilization for each enrollee).</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBAAA9C68C6B24798AB98B7C4285813AA"><enum>(B)</enum><header>Data access</header><clause id="H2512D899A2DE4C94800F72AFAF81E54A"><enum>(i)</enum><header>In general</header><text>Not later than January 1 of the year that is two years after the beginning of a plan year for which data is submitted under subparagraph (A), the Secretary shall—</text><subclause id="H47247EDF3D604DEB84C8F911630B649E"><enum>(I)</enum><text>upon request, make such data available to individuals and entities for the purpose of conducting—</text><item id="H332DA527970042D6BF908C463755327C" commented="no" display-inline="no-display-inline"><enum>(aa)</enum><text display-inline="yes-display-inline">evaluations and other analyses to support the program under this title; and</text></item><item id="HC5BF288973BF4127ADC99F04627ADEB8" commented="no" display-inline="no-display-inline"><enum>(bb)</enum><text>other health care related research; and</text></item></subclause><subclause id="HC75B0C9EF95C49AD89D64B52A8866A78"><enum>(II)</enum><text>make available on the internet website of the Centers for Medicare &amp; Medicaid Services a public use data file containing such data in de-identified form.</text></subclause></clause><clause id="H7B9F62CCEB58413983D4B3F3D299EC60" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><header>Confidentiality</header><text>In making data available under clause (i)(I), the Secretary shall have in place procedures to safeguard the privacy and security of any individually identifiable enrollee information.</text></clause></subparagraph><subparagraph id="HE44F6B68709D43FF94BFE6C35B955B4E"><enum>(C)</enum><header>Nonapplication of Paperwork Reduction Act</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/44/35">Chapter 35</external-xref> of title 44, United States Code, shall not apply to data collected under subparagraph (A).</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection commented="no" display-inline="no-display-inline" id="HB9AA72A0E8CD40ADA85E9A737A8C23FF"><enum>(b)</enum><header>Rule of construction</header><text>Nothing in the amendment made by this section shall affect the collection of information as proposed, or so finalized, pursuant to the notice entitled <quote>Agency Information Collection Activities: Proposed Collection; Comment Request</quote>, published in the Federal Register on March 14, 2023 (88 Fed. Reg. 15726).</text></subsection><subsection id="HEC6EA12749E54A5096065D6B2B941601"><enum>(c)</enum><header>Implementation funding</header><text display-inline="yes-display-inline">For the purposes of carrying out the amendment made by this section, there are appropriated, out of amounts in the Treasury not otherwise appropriated, to the Secretary of Health and Human Services, $15,000,000 for fiscal year 2024, to remain available until expended. </text></subsection></section></legis-body></bill> 

