H. R. 6809
IN THE HOUSE OF REPRESENTATIVES
September 13, 2018
Miss González-Colón of Puerto Rico (for herself, Mr. Serrano, Mr. Bacon, Mr. Soto, and Mrs. Murphy of Florida) 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
To amend title XVIII of the Social Security Act to provide for temporary stabilization of Medicare Advantage payments following Hurricane Maria.
This Act may be cited as the
Puerto Rico Integrity in Medicare Advantage Act.
Temporary stabilization of Medicare Advantage payments following Hurricane Maria
Section 1853(n) of the Social Security Act (42 U.S.C. 1395w–23(n)) is amended—
in paragraph (1)(B), by striking
subsequent year and inserting
subsequent year, subject to paragraph (7),;
in paragraph (4), by striking
In and inserting
Subject to paragraph (7), in; and
by adding at the end the following new paragraph:
Average geographic adjustment floor
For each of 2019, 2020, and 2021, when calculating the adjusted average capital amount under section 1876(a)(4) for the purposes of establishing the base payment amount, the average geographic adjustment shall not be less than 0.70 for any area.
Ensuring payments flow to Puerto Rico providers and patients
Section 1854(a)(6) of the Social Security Act (42 U.S.C. 1395w–24(a)(6)) is amended—
in subparagraph (B)(iv)—
Exception.—In the case of and inserting
In the case of
by adding at the end the following new subclause:
In the case of an area to which section 1853(n)(7) applies with respect to a year, clause (iii) shall be waived for bids submitted for such area and year and subparagraph (C) shall apply.
by adding at the end the following new subparagraph:
Strengthening support to health care providers in Puerto Rico
When reviewing bids submitted by plans serving areas in Puerto Rico, the Secretary shall ensure that, of the increase in blended benchmark amount attributable to section 1853(n)(7) (above the amount that would otherwise be determined under section 1853(n)), no less than 50 percent is directed toward provider compensation.