Medicare
US Congress 116th Congress
Medicare Dental Benefit Act of 2019 [S.22]
Provides for Medicare coverage of dental and oral health services, including routine diagnostic and preventive services, basic and major dental services, and emergency care; dental prostheses are also covered. Currently, such services are excluded from Medicare coverage.
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Health Savings Act of 2019 [S.12]
Modifies the requirements for health savings accounts (HSAs) to rename high deductible health plans as HSA-qualified health plans; allow spouses who have both attained age 55 to make catch-up contributions to the same HSA; make Medicare Part A (hospital insurance benefits) beneficiaries eligible to participate in an HSA; allow individuals eligible for hospital care or medical services under a program of the Indian Health Service or a tribal organization to participate in an HSA; allow members of a health care sharing ministry to participate in an
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Keeping Health Insurance Affordable Act of 2019 [S.3]
Alters and establishes several programs relating to health insurance and prescription drugs. Specifically, the bill requires the Department of Health and Human Services (HHS) to establish a public health insurance option through health insurance exchanges. The bill sets forth corresponding implementing provisions, including criteria for payment rates and provider participation. (For example, initial payment rates for providers and services must be set at the same rates as under Medicare; HHS may subsequently alter payment rates in accordance with
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Expressing the sense of the House of Representatives that Medicare and Social Security provide an essential benefit for current enrollees and should be strengthened for future generations. [HR-59]
This resolution affirms the House of Representatives' obligation to fulfill the promises made to senior citizens of the United States regarding access to Medicare and Social Security. It also rejects any changes to Medicare or Social Security that diminish benefits for Americans currently enrolled, or soon to be enrolled, in the Medicare program or the Old Age, Survivors, and Disability Insurance program. The resolution also expresses the House's commitment that these programs should be strengthened and preserved, and expresses support for efforts
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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. [HB-1052]
Allows direct payment, under the Medicare program, to physician assistants for certain services furnished to enrollees.
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Medicare Negotiation and Competitive Licensing Act of 2019 [HB-1046]
Requires the Centers for Medicare & Medicaid Services (CMS) to negotiate with pharmaceutical companies regarding prices for drugs covered under the Medicare prescription drug benefit. (Current law prohibits the CMS from doing so.) The CMS must take certain factors into account during negotiations, including the clinical- and cost-effectiveness of the drug, the financial burden on patients, and unmet patient needs. If the CMS is unable to negotiate the price of a drug, such drug is subject to competitive licensing in order to further its sale under
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Critical Access Hospital Relief Act of 2019 [HB-1041]
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.
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Prescription Drug Price Transparency Act [HB-1035]
Establishes additional requirements for prescription drug plan sponsors (PDPs) under Medicare and Medicare Advantage, as well as health insurance carriers under the Federal Employees Health Benefits Program, relating to the methodology of payments to pharmacies and the use of pharmacy benefits managers (PBMs). Specifically, such PDPs and carriers must disclose specified information to pharmacies regarding applicable standards for reimbursement that are based on drug costs, including the sources used to update such standards. Additionally, such PDPs
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Phair Pricing Act of 2019 [HB-1034]
Requires that certain negotiated prices for covered drugs under the Medicare prescription drug benefit be disclosed at the point-of-sale. Specifically, negotiated prices offered under a prescription drug plan (PDP) must be disclosed at the point-of-sale; the disclosed price must include specified adjustments, payments, and fees that are negotiated with the pharmacy (e.g., dispensing fees) by the PDP sponsor or pharmacy benefit manager. Additionally, the Centers for Medicare & Medicaid Services must establish certain quality measures for PDP sponsors
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Mental Health Access Improvement Act of 2019 [HB-945]
Provides for coverage of marriage and family therapist services and mental health counselor services under Medicare. It also excludes such services from the skilled nursing facility prospective payment system, and authorizes marriage and family therapists and mental health counselors to develop discharge plans for post-hospital services.
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North American Wetlands Conservation Extension Act [HB-925]
Reauthorizes the North American Wetlands Conservation Act through FY2024.
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Stop Penalizing Working Seniors Act [HB-908]
Allows Medicare-eligible individuals who are age 65 or older to contribute to health savings accounts if their entitlement to Medicare benefits is limited to hospital insurance benefits under Medicare Part A.
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ACO Assignment Improvement Act of 2019 [HB-900]
Establishes additional requirements for assigning Medicare fee-for-service beneficiaries to accountable care organizations (ACOs) under the Medicare shared savings program. Under current law, the program enables ACOs to receive payments for savings stemming from care coordination and management. The bill requires the basis for assignment to reflect beneficiaries' utilization of not only primary care services provided by ACO physicians, but also those provided by other ACO practitioners—specifically, physician assistants, nurse practitioners, and
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Medicare Mental Health Access Act [HB-884]
Expands the definition of "physician," for purposes of the Medicare program, to include a clinical psychologist with respect to the furnishing of qualified psychologist services.
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End Surprise Billing Act of 2019 [HB-861]
Requires a critical access hospital or other hospital to comply, as a condition of participation in Medicare, with certain requirements related to billing for out-of-network services. With respect to an individual who has health benefits coverage and is seeking services, a hospital must provide notice as to (1) whether the hospital, or any of the providers furnishing services to the individual at the hospital, is not within the health care provider network or otherwise a participating provider with respect to the individual's health care coverage;
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Puerto Rico Integrity in Medicare Advantage Act [HB-813]
Temporarily establishes geographic adjustments for certain Medicare Advantage payment formulations, and specifies that a certain percentage of corresponding payment increases must be directed toward compensating providers in Puerto Rico.
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Promoting Access to Diabetic Shoes Act [HB-808]
Allows a nurse practitioner or physician assistant to fulfill documentation requirements for coverage, under Medicare, of special shoes for diabetic individuals. Under current law, such requirements may be satisfied only by a physician.
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Improving Transparency and Accuracy in Medicare Part D Spending Act [HB-803]
Prohibits Medicare prescription drug plan sponsors from retroactively reducing payment on clean claims submitted by pharmacies. (A "clean claim" is a Medicare claim that is free of defects such as incomplete documentation.)
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Improving Transparency and Accuracy in Medicare Part D Spending Act [HB-789]
Prohibits Medicare prescription drug plan sponsors from retroactively reducing payment on clean claims submitted by pharmacies. (A "clean claim" is a Medicare claim that is free of defects such as incomplete documentation.)
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Middle Class Health Benefits Tax Repeal Act of 2019 [HB-748]
Responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. DIVISION A--KEEPING WORKERS PAID AND EMPLOYED, HEALTH CARE SYSTEM ENHANCEMENTS, AND ECONOMIC STABILIZATION This division establishes the Paycheck Protection Program to provide eight weeks of cash flow assistance to small businesses through federally guaranteed loans to employers who maintain their payroll. Such assistance shall be to cover costs such as payroll, paid sick leave,
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