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US S1961
US S1961Improving the Treatment of the U.S. Territories Under Federal Health Programs Act of 2015
summary
Introduced
08/05/2015
08/05/2015
In Committee
08/05/2015
08/05/2015
Crossed Over
Passed
Dead
01/03/2017
01/03/2017
Introduced Session
114th Congress
Bill Summary
Improving the Treatment of the U.S. Territories Under Federal Health Programs Act of 2015 This bill amends title XIX (Medicaid) of the Social Security Act (SSAct) to: (1) terminate limitations on general Medicaid funding, as well as the specific federal medical assistance percentage, for U.S. territories; (2) extend to additional U.S. territories the authority to waive or modify certain Medicaid requirements; and (3) establish a formula for Medicaid disproportionate share hospital (DSH) payments to the territories. Federal financial participation shall generally not be available to a territory for medical assistance for an individual whose family income exceeds 100% percent of the official poverty line for a family of that size. The bill also amends title XVIII (Medicare) of the SSAct to: (1) revise the formula for the Medicare inpatient hospital services payment rate for hospitals in Puerto Rico to increase the applicable federal percentage from 75% to 100%, (2) apply Medicare HITECH (Health Information Technology for Economic and Clinical Health Act) payments to certain hospitals in Puerto Rico, (3) establish a formula element for calculating Medicare DSH payments under the inpatient prospective payment system for certain hospitals in Puerto Rico, (4) allow residents of Puerto Rico to enroll under Medicare hospital services, (5) increase the geographic adjustment practice expense index for Puerto Rico, and (6) alter how U.S territories are treated under Medicare Advantage and the Medicare prescription drug benefit.
AI Summary
This bill, the Improving the Treatment of the U.S. Territories Under Federal Health Programs Act of 2015, aims to enhance how U.S. territories are treated under federal health programs like Medicaid and Medicare. For Medicaid, it proposes to remove limitations on overall federal funding and specific federal matching rates for territories, allow more territories to modify certain Medicaid rules, and establish a new way to calculate payments for hospitals that serve a disproportionate number of low-income patients (known as Disproportionate Share Hospital or DSH payments), while also limiting federal Medicaid funding for individuals with incomes above 100% of the federal poverty line. For Medicare, the bill revises payment rates for hospitals in Puerto Rico, extends certain technology adoption incentives (HITECH payments) to Puerto Rico hospitals, adjusts how DSH payments are calculated for these hospitals, allows Puerto Rico residents to enroll in Medicare hospital services, increases a geographic adjustment factor for medical services in Puerto Rico, and modifies how territories are treated under Medicare Advantage plans and the Medicare prescription drug benefit.
Committee Categories
Budget and Finance
Sponsors (6)
Chuck Schumer (D)*,
Richard Blumenthal (D),
Cory Booker (D),
Kirsten Gillibrand (D),
Bob Menendez (D),
Bill Nelson (D),
Last Action
Read twice and referred to the Committee on Finance. (on 08/05/2015)
Official Document
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