Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act

Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act

This bill temporarily establishes geographic adjustments for certain Medicare Advantage payment formulations, and specifies that a certain percentage of corresponding payment increases must be directed toward payments for basic benefits. It also requires U.S. territories to establish Medicare Savings Programs (currently optional in the territories).

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7997 Introduced in House (IH)]

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117th CONGRESS
  2d Session
                                H. R. 7997

To amend title XVIII of the Social Security Act to establish a floor in 
 Medicare Advantage benchmark rates for regions with low Medicare fee-
   for-service penetration and to make the Medicare Savings Program 
                    available in all jurisdictions.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 9, 2022

Miss Gonzalez-Colon (for herself, Mr. Soto, Ms. Velazquez, Ms. Salazar, 
    Mr. Crist, Mr. Fitzpatrick, Mr. Bacon, Mr. Espaillat, and Mrs. 
  Radewagen) introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, 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 establish a floor in 
 Medicare Advantage benchmark rates for regions with low Medicare fee-
   for-service penetration and to make the Medicare Savings Program 
                    available in all jurisdictions.

    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 ``Achieving Equity in the Treatment of 
Dual Eligible Beneficiaries Act''.

SEC. 2. ADDRESSING DISPARITIES IN MEDICARE ADVANTAGE BENCHMARK LEVELS 
              BASED ON PENETRATION.

    (a) In General.--Section 1853(n) of the Social Security Act (42 
U.S.C. 1395w-23(n)) is amended--
            (1) in paragraph (1)(B), by striking ``subsequent year'' 
        and inserting ``subsequent year, subject to paragraph (6),''; 
        and
            (2) by adding at the end the following new paragraph:
            ``(6) Average geographic adjustment floor.--For 2024 and 
        subsequent years, when calculating the adjusted average per 
        capita cost under section 1876(a)(4) for the purposes of 
        establishing the base payment amount specified in paragraph 
        (2)(E), the average geographic adjustment shall not be less 
        than 0.70 for any area. For the purposes of the previous 
        sentence, the Secretary may define the term `average geographic 
        adjustment' under subparagraph (A) by program instruction or 
        otherwise.''.
    (b) Ensuring Plan Payments Flow to Providers and Patients.--Section 
1854(a)(6) of the Social Security Act (42 U.S.C. 1395w-24(a)(6)) is 
amended by adding at the end the following new subparagraph:
                    ``(C) Ensuring increased payments support care.--
                With respect to the increase in blended benchmark 
                amount attributable to the application of section 
                1853(n)(6), no less than 50 percent shall be directed 
                toward payment for basic benefits as defined in section 
                1852(a)(1)(B).''.

SEC. 3. EXPANDING THE MEDICARE SAVINGS PROGRAM TO THE TERRITORIES.

    Section 1905(p)(4) of the Social Security Act (42 U.S.C. 
1396d(p)(4)) is amended by inserting ``for fiscal years through 2022'' 
after ``Columbia)''.
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