Medicare
US Congress 116th Congress
Treat and Reduce Obesity Act of 2019 [S.595]
Expands Medicare coverage of intensive behavioral therapy for obesity. Specifically, the bill allows coverage for therapy that is provided by (1) a physician who is not a primary care physician; or (2) other health care providers (e.g., physician assistants and nurse practitioners) and approved counseling programs, if provided upon a referral from, and in coordination with, a physician or primary care practitioner. Currently, such therapy is covered only if provided by a primary care practitioner. The bill also allows coverage under Medicare's prescription
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Sponsored by: Sen. Amy Klobuchar
Read Twice And Referred To The Committee On Finance. on 02/28/2019
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A bill to amend title XVIII of the Social Security Act to provide for direct payment to physician assistants under the Medicare program for certain services furnished by such physician assistants. [S.596]
Allows direct payment, under the Medicare program, to physician assistants for certain services furnished to enrollees.
Sponsored by: Sen. Kevin Cramer
Read Twice And Referred To The Committee On Finance. on 02/28/2019
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Medicare Dental, Vision, and Hearing Benefit Act of 2019 [HB-1393]
Provides for Medicare coverage of dental, vision, and hearing care. Coverage includes (1) routine dental cleanings and exams, basic and major dental services, emergency dental care, and dentures; (2) routine eye exams, eyeglasses, and contact lenses; and (3) routine hearing exams, hearing aids, and exams for hearing aids. With respect to such care, the bill establishes special payment rules, limitations, and coinsurance requirements.
Sponsored by: Rep. Raul Grijalva
Referred To The Subcommittee On Health. on 03/01/2019
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Medigap Consumer Protection Act of 2019 [HB-1394]
(1) expands guaranteed issue rights with respect to Medigap policies (Medicare supplemental health insurance policies), (2) eliminates certain limitations on Medigap policies for newly eligible Medicare beneficiaries, and (3) modifies other provisions related to Medigap policies. (Guaranteed issue rights require that a policy be offered to any eligible applicant without regard to health status.)
Sponsored by: Rep. Raul Grijalva
Referred To The Subcommittee On Health. on 03/01/2019
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Medicare for All Act of 2019 [HB-1384]
Establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and
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Sponsored by: Rep. Raul Grijalva
Subcommittee Hearings Held. on 12/10/2019
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Medicare for All Act of 2019 [HB-1384]
Establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and
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Sponsored by: Rep. Raul Grijalva
Subcommittee Hearings Held. on 12/10/2019
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Transparency in All Health Care Pricing Act of 2019 [HB-1409]
Requires the health care industry to publicly disclose the prices of products and services. Specifically, the bill requires entities that offer or furnish health care related products or services to the public, including health insurers and government agencies, to disclose the price for those products and services at the point of purchase and on the internet. The entities must disclose all prices, including wholesale, retail, and discounted prices, that are accepted as payment in full for products and services furnished to individual consumers.
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Sponsored by: Rep. James McGovern
Referred To The Subcommittee On Health. on 03/01/2019
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Mobile Health Record Act of 2019 [HB-1390]
Requires the Centers for Medicare & Medicaid Services (CMS) to establish a program that enables Medicare enrollees to connect claims data with trusted applications, services, and research programs. The program must allow an enrollee to access claim information through a mobile health record application that is chosen by the enrollee and that is also approved by the CMS, in accordance with specified requirements. Information must be made available to such applications in a similar manner as under the current Blue Button 2.0 program. The bill also
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Sponsored by: Rep. Yvette Clarke
Referred To The Subcommittee On Health. on 03/01/2019
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Critical Access Hospital Relief Act of 2019 [S.586]
Repeals the 96-hour physician-certification requirement for inpatient critical access hospital services under Medicare. Under current law, as a condition for Medicare payment for such services, a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital.
Sponsored by: Sen. Mike Rounds
Read Twice And Referred To The Committee On Finance. on 02/27/2019
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Breast Cancer Patient Equity Act [S.562]
Provides for Medicare coverage of custom fabricated breast prostheses following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses. Currently, Medicare covers surgically implanted breast prostheses, as well as some external breast prostheses (e.g., post-surgical bras).
Sponsored by: Sen. Amy Klobuchar
Read Twice And Referred To The Committee On Finance. on 02/26/2019
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PAID Act Provide Accurate Information Directly Act [HB-1375]
Requires the Centers for Medicare & Medicaid Services to provide, in response to an inquiry from certain non-group health plans (e.g., liability insurers), whether an individual was enrolled in Medicare, Medicare Advantage, or the Medicare prescription drug benefit during the preceding three-year period. The bill also restores available funding to the Medicare Improvement Fund.
Sponsored by: Rep. Gus Bilirakis
Received In The Senate And Read Twice And Referred To The Committee On Finance. on 12/09/2020
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Breast Cancer Patient Equity Act [HB-1370]
Provides for Medicare coverage of custom fabricated breast prostheses following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses. Currently, Medicare covers surgically implanted breast prostheses, as well as some external breast prostheses (e.g., post-surgical bras).
Sponsored by: Rep. James McGovern
Referred To The Subcommittee On Health. on 02/27/2019
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Advancing Medical Resident Training in Community Hospitals Act of 2019 [HB-1358]
Revises payment rules under Medicare for graduate medical education (GME) costs with respect to a hospital that establishes a new medical residency training program. If a hospital has not entered into a GME affiliation agreement, the Centers for Medicare & Medicaid Services (CMS) must establish the hospital's full-time equivalent (FTE) resident amount only after determining that the hospital's medical residency training program trains more than 1.0 FTE resident in a cost reporting period. If a hospital has an approved FTE resident amount that is
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Sponsored by: Rep. Eleanor Norton
Referred To The Subcommittee On Health. on 02/27/2019
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REFUND Act of 2019 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 [S.551]
Requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) in relation to discarded amounts (i.e., amounts remaining after administration) of single-dose vial drugs that are covered under Medicare. Manufacturers that fail to comply are subject to civil penalties. The CMS must determine rebate amounts based on payment claims from providers. (Currently, providers may receive payment under Medicare for discarded amounts of single-dose vial drugs through the use of a specific claims modifier.)
Sponsored by: Sen. Rob Portman
Read Twice And Referred To The Committee On Finance. (text Of Measure As Introduced: Cr S1439) on 02/25/2019
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Territories Health Equity Act of 2019 [HB-1354]
Alters provisions under Medicaid, Medicare, and Medicare Advantage relating to U.S. territories, and generally modifies and establishes programs to expand health insurance coverage for residents. Among other things, the bill eliminates Medicaid funding limitations for U.S. territories beginning in FY2020; repeals provisions that exclude residents of Puerto Rico from a certain automatic enrollment process for Medicare medical services; establishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within
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Sponsored by: Rep. Barbara Lee
Referred To The Subcommittee On Health. on 02/26/2019
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Medicare Buy-In and Health Care Stabilization Act of 2019 [HB-1346]
Establishes a Medicare buy-in option for certain qualifying individuals and makes a series of other changes relating to health care costs. Specifically, the bill allows individuals aged 50 to 64 to enroll in Medicare if such individuals would otherwise qualify for Medicare at the age of 65. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations
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Sponsored by: Rep. Sean Maloney
Subcommittee Hearings Held. on 12/10/2019
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Restoring the Partnership for County Health Care Costs Act of 2019 [HB-1345]
Allows an otherwise eligible individual who is in custody pending disposition of charges (i.e., pretrial detainees) to receive Supplemental Security Income (SSI), Medicare, Medicaid, or Children's Health Insurance Program (CHIP) benefits. Any SSI benefits payable to such an individual (1) must be withheld until the individual is no longer in custody; and (2) if the individual dies while in custody, shall be paid to the individual's estate.
Sponsored by: Rep. Raul Grijalva
Referred To The Subcommittee On Health. on 02/26/2019
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To address the high costs of health care services, prescription drugs, and health insurance coverage in the United States, and for other purposes. [HB-1332]
Addresses the health care system, including Medicare, Medicaid, the private health insurance market, and the prescription drug approval process. The bill also revises tax provisions related to certain health care costs and establishes requirements for lawsuits involving health care provided, at least in part, through a federal program or with federal funds.
Sponsored by: Rep. Bruce Westerman
Referred To The Subcommittee On Military Personnel. on 02/26/2019
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Workplace Violence Prevention for Health Care and Social Service Workers Act [HB-1309]
Requires the Department of Labor to address workplace violence in the health care and social service sectors. Specifically, Labor must promulgate an occupational safety and health standard that requires certain employers in the health care and social service sectors, as well as employers in sectors that conduct activities similar to the activities in the health care and social service sectors, to develop and implement a comprehensive plan for protecting health care workers, social service workers, and other personnel from workplace violence. In
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Sponsored by: Rep. Sean Maloney
Debate - Pursuant To The Provisions Of H. Res. 713, The Committee Of The Whole Proceeded With 10 Minutes Of Debate On The Delgado Amendment No. 10. on 11/21/2019
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Mental Health Telemedicine Expansion Act [HB-1301]
Excludes certain mental health telehealth services from specified requirements under Medicare, including originating site requirements.
Sponsored by: Rep. Jamie Raskin
Referred To The Subcommittee On Health. on 02/19/2019