Addressing Social Determinants in Medicare Advantage Act of 2021
This bill allows Medicare Advantage plans to offer certain supplemental benefits that are currently only available to chronically ill enrollees to enrollees with low-income or who meet other criteria, such as socioeconomic risk factors.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4074 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 4074
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
June 23, 2021
Mr. Bilirakis 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 Social Determinants in
Medicare Advantage Act of 2021''.
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; and
``(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, 2023.
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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