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H.R. 813: Puerto Rico Integrity in Medicare Advantage Act

The text of the bill below is as of Jan 28, 2019 (Introduced).


I

116th CONGRESS

1st Session

H. R. 813

IN THE HOUSE OF REPRESENTATIVES

January 28, 2019

(for herself, Mr. Serrano, Mr. Fitzpatrick, Mr. Soto, Ms. Velázquez, Mrs. Radewagen, and Mr. King of New York) 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 provide for temporary stabilization of Medicare Advantage payments following Hurricane Maria.

1.

Short title

This Act may be cited as the Puerto Rico Integrity in Medicare Advantage Act.

2.

Temporary stabilization of Medicare Advantage payments following Hurricane Maria

(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 each of 2020, 2021, and 2022, 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 purposes of the previous sentence, the Secretary may define the term average geographic adjustment by program instruction or otherwise.

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(b)

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 by adding at the end the following new subparagraph:

(C)

Strengthening support to health care providers in Puerto Rico

With respect to plans serving areas in Puerto Rico, of the increase in blended benchmark amount attributable to section 1853(n)(6), no less than 50 percent is directed toward provider compensation.

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