Bill
Bill > HR3168
summary
Introduced
07/06/2017
07/06/2017
In Committee
07/13/2017
07/13/2017
Crossed Over
Passed
Dead
12/31/2018
12/31/2018
Introduced Session
115th Congress
Bill Summary
SNP Reauthorization Act of 2017 Special Needs Plans Reauthorization Act of 2017 (Sec. 2) This bill allows a Medicare Advantage (MA) plan, until 2024, to restrict plan enrollment to certain special-needs individuals, provided that the plan meets specified applicable requirements. Current law allows an MA plan to do so until 2019. The Federal Coordinated Health Care Office within the Centers for Medicare & Medicaid Services (CMS) shall serve as a dedicated point of contact for states with regard to special-needs MA plans for individuals who are dually eligible for Medicaid and Medicare. The CMS shall establish a unified process for grievances and appeals for individuals enrolled in such plans. The CMS must, with respect to special-needs MA plans for individuals with chronic conditions, convene a panel of clinical advisors to establish and update the list of chronic conditions that make an individual eligible for participation in such a plan. The Government Accountability Office (GAO) must study and report to Congress on health outcomes of individuals enrolled in specialized MA plans. The CMS shall, with respect to special-needs MA plans, consider applying certain quality measures at the plan level rather than at the contract level. The GAO must report to Congress on state-level integration between the Medicaid program and special-needs MA plans for individuals who are dually eligible for Medicaid and Medicare. (Sec. 3) Beginning in plan year 2020, an MA plan may provide certain supplemental benefits to chronically ill enrollees. The GAO must report to Congress on the provision of such supplemental benefits to MA enrollees.
AI Summary
This bill:
Extends the ability of Medicare Advantage (MA) plans to restrict enrollment to special needs individuals until 2024 (currently allowed until 2019). It establishes the Federal Coordinated Health Care Office as a dedicated point of contact for states on integrating specialized MA plans for dual-eligible individuals (those enrolled in both Medicare and Medicaid). The bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a unified grievance and appeals process for specialized MA plans, and sets integration requirements for certain dual-eligible special needs plans starting in 2021. It also directs CMS to convene a panel to establish and update the list of chronic conditions that qualify individuals for enrollment in specialized MA plans for individuals with chronic conditions. Additionally, the bill allows MA plans to provide supplemental benefits tailored for chronically ill enrollees starting in 2020, and requires a GAO study on the provision of such supplemental benefits.
Committee Categories
Budget and Finance, Health and Social Services
Sponsors (2)
Last Action
Placed on the Union Calendar, Calendar No. 353. (on 12/21/2017)
Official Document
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
Loading...