Healthcare

Patient Access and Medicare Protection Act

United States · United States Congress · 18 December 2015

Patient Access and Medicare Protection Act This bill temporarily exempts from certain Medicare payment adjustments wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehabilitative power wheelchairs. (Group 3 power wheelchairs are those that meet the highest performance requirements with regard to speed, range, and climbing capability.) In addition, the bill amends title XVIII (Medicare) of the Social Security Act (SSAct) to prohibit specified adjustments to the Medicare fee schedule for certain radiation therapy services in 2017 or 2018. For 2017, the Centers for Medicare & Medicaid Services (CMS) may exempt categories of eligible professionals from requirements for meaningful use of electronic health records (EHR). The bill eliminates funding for the Medicare Improvement Fund. (The fund was established to make improvements under the original Medicare fee-for-service program.) The bill also amends title XIX (Medicaid) of the SSAct to make several changes related to the prevention of Medicaid fraud. Under current law, CMS may contract with Medicare administrative contractors (MACs), which are private insurers that process Medicare claims within specified geographic jurisdictions. The bill requires CMS to provide specified incentives for MACs to reduce improper payment error rates within their jurisdictions. The bill establishes criminal penalties of up to 10 years imprisonment and up to $500,000 ($1,000,000 for corporations) in fines for illegally purchasing or distributing Medicare, Medicaid, or Children's Health Insurance Program (CHIP) beneficiary identification or billing privileges. The bill increases the scope of the Medicare-Medicaid Data Match Program (Medi-Medi Program), an existing program through which contractors and participating governmental agencies collaboratively analyze Medicare and Medicaid billing trends. CMS must establish a plan to encourage states to participate in the Medi-Medi Program.

Obamacare Tax Transparency Act

United States · United States Congress · 18 December 2015

Obamacare Tax Transparency Act This bill amends the Public Health Service Act to require health insurers to disclose to individuals and employers who pay health insurance premiums the portion of premiums attributable to the annual fee imposed on health insurers.

Early Hearing Detection and Intervention Act of 2015

United States · United States Congress · 18 December 2015

Early Hearing Detection and Intervention Act of 2015 This bill amends the Public Health Service Act to expand programs for deaf and hard-of-hearing newborns and infants to include young children. The programs are revised and reauthorized for FY2016-FY2020.

A bill making appropriations to address the heroin and opioid drug abuse epidemic for the fiscal year ending September 30, 2016, and for other purposes.

United States · United States Congress · 18 December 2015

This bill provides FY2016 supplemental appropriations for the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) to address heroin and opioid drug abuse. The funds are designated as an emergency requirement, which exempts the funds from discretionary spending limits and other budget enforcement rules. For DOJ, the bill provides funds for State and Local Law Enforcement Assistance and Community Oriented Policing Services (COPS) programs. For HHS, the bill provides funds for: the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Public Health and Social Services Emergency Fund.

A resolution designating January 2016 as "National Carbon Monoxide Poisoning Awareness Month".

United States · United States Congress · 18 December 2015

Designates January 2016 as National Carbon Monoxide Poisoning Awareness Month.

Patient Opportunity Protection Act of 2015

United States · United States Congress · 18 December 2015

Patient Opportunity Protection Act of 2015 This bill amends the Public Health Service Act to prohibit the Department of Health and Human Services (HHS) from imposing additional conditions on excepted benefits, which are health benefits that are not subject to requirements applicable to group health plans or individual health insurance. In the individual health insurance market, HHS may not condition the treatment of fixed indemnity insurance as an excepted benefit on the beneficiary satisfying the requirement for minimum essential coverage. The amendments made by this bill are retroactively effective as if included in the Patient Protection and Affordable Care Act.

Synchronization & Nonadherence Correction (SYNC) Act of 2015

United States · United States Congress · 18 December 2015

Synchronization & Nonadherence Correction (SYNC) Act of 2015 This bill requires the Department of Health and Human Services (HHS) to research and test methods for improving medication adherence. "Medication adherence" refers to the taking of medications according to their prescribed dosage, time, frequency, and direction. Research activities shall include the development of annual statistics related to medication adherence for patients with chronic diseases and mental health conditions treated under Medicare, Medicaid, and the Federal Employees Health Benefit Program. HHS shall implement innovative health care delivery models to test: (1) the efficacy of "synchronization," which refers to the coordination of medication refills such that a patient's medications are refilled according to the same schedule; and (2) 90-day fills at retail pharmacies for the first prescription of maintenance drugs that treat chronic diseases and mental health conditions.

Tribal Veterans Health Care Enhancement Act

United States · United States Congress · 17 December 2015

Tribal Veterans Health Care Enhancement Act This bill amends the Indian Health Care Improvement Act to allow the Indian Health Service (IHS) to pay copayments owed to the Department of Veterans Affairs (VA) by Indian veterans for services authorized under the Purchased/Referred Care program. The IHS and the VA, in consultation with impacted Indian tribes, must enter into a memorandum of understanding that authorizes the IHS to pay such copayments unless it would decrease the quality of, or access to, health care for individuals receiving care from the IHS or the VA. The IHS and the VA must report on veterans who are IHS beneficiaries and have received care from the VA.

VERIFI Act

United States · United States Congress · 17 December 2015

Verifying Electronically the Receipt of In-Home Care For Individuals Act or the VERIFI Act This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require the use of electronic visit verification systems for certain services under the Medicare and Medicaid programs. An "electronic visit verification system" is a system under which care-related visits are electronically verified with regard to: (1) the type and date of service, (2) the individual receiving the service, (3) the individual providing the service, (4) the location of service delivery, and (5) the time the service begins and ends. With respect to the Medicare program, a home health agency must have such a system in place for home health services as a condition of participation. In the case of a state Medicaid program that does not require the use of such a system for both personal care services and home health services, the federal medical assistance percentage for medical assistance expended on such services shall be reduced beginning in 2019. These reductions increase incrementally from 0.25% to 1.00% through 2023. With respect to the Medicare program, the Centers for Medicare & Medicaid Services shall establish standards for the systems and must consult with agencies to ensure that such standards: (1) are minimally burdensome, (2) account for existing best practices and electronic visit verifications systems already in use, and (3) require that the systems are conducted in accordance with specified legal requirements related to privacy and security. In regard to a state Medicaid program, a state shall do the same.

Behavioral Health Coverage Transparency Act of 2015

United States · United States Congress · 16 December 2015

Behavioral Health Coverage Transparency Act of 2015 This bill amends the Public Health Service Act, Employee Retirement Income Security Act of 1974 (ERISA), and Internal Revenue Code to direct the Departments of Health and Human Services (HHS), Labor, and the Treasury to require group health plans and health insurers to disclose the analyses performed to ensure compliance of plans or coverage with the law and regulations. Disclosures must include findings and conclusions regarding whether nonquantitative treatment limitations (e.g., tiered benefits, step therapy, or preauthorization) applied to mental health or substance use disorder benefits are comparable to, and applied no more stringently than, such limitations on medical and surgical benefits. HHS, Labor, and Treasury must: (1) issue guidance on the process for current and potential participants and beneficiaries to file formal complaints of plans or insurers being in violation of the requirement for parity between mental health and substance use disorder benefits and medical and surgical benefits, (2) conduct audits of plans and insurers to determine compliance with parity requirements and publish information from those audits, and (3) publish information on denials of claims by plans and insurers for mental health and substance use disorder services compared to denials of claims for medical and surgical services. HHS must establish a consumer parity portal website that allows for submission of complaints and provides information to consumers on parity. The Government Accountability Office must report on HHS, Labor, and Treasury efforts to enforce parity.

Nurse and Health Care Worker Protection Act of 2015

United States · United States Congress · 16 December 2015

Nurse and Health Care Worker Protection Act of 2015 This bill requires the Department of Labor to establish a standard on safe patient handling, mobility, and injury prevention to prevent musculoskeletal disorders for health care workers. The standard must require the use of engineering and safety controls to handle patients. The standard must require health care employers to: (1) develop and implement a safe patient handling, mobility, and injury prevention program; (2) train their workers on safe patient handling, mobility, and injury prevention; and (3) post a notice that explains the standard, procedures to report patient handling-related injuries, and workers' rights under this Act. Labor must conduct unscheduled inspections to ensure compliance with the standard. This bill amends title XVIII (Medicare) of the Social Security Act to apply the standard to hospitals receiving Medicare funds.

Medicare Mental Health Access Act

United States · United States Congress · 16 December 2015

Medicare Mental Health Access Act This bill amends title XVIII (Medicare) of the Social Security Act to expand the definition of "physician," for purposes of the Medicare program, to include a clinical psychologist with respect to the furnishing of qualified psychologist services. The bill excludes a clinical psychologist, in 2017 and 2018, from certain negative payment adjustments for failing to be a meaningful electronic health records user.

Medicare Advantage Quality Payment Relief Act of 2015

United States · United States Congress · 16 December 2015

Medicare Advantage Quality Payment Relief Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare & Medicaid to disregard the application of certain percentage quality increases when calculating the maximum payment that may be made to a Medicare Advantage organization.

Medicare and Medicaid Improvements and Adjustments Act of 2015

United States · United States Congress · 16 December 2015

Medicare and Medicaid Improvements and Adjustments Act of 2015 This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify payment rules and other provisions related to the Medicare and Medicaid programs. The bill includes off-campus outpatient department (OPD) services in Medicare's prospective payment system (in which predetermined amounts form the basis of payment) with respect to departments that are under development. The existing Medicare payment adjustment for cancer hospitals shall apply to off-campus OPDs. The bill temporarily prohibits specified Medicare payment adjustments related to competitive acquisition programs for certain wheelchair accessories. In addition, the bill modifies provisions related to: (1) reimbursement under Medicare for certain drugs furnished through durable medical equipment (DME), (2) Medicare payment rules for certain radiation therapy services, and (3) the treatment of Medicaid supplemental needs trusts. The bill expands criminal penalties and civil monetary penalties for certain acts involving federal health care programs. With respect to negative Medicare payment adjustments for physicians and hospitals that fail to comply with certain requirements related to electronic health records (EHR), the bill authorizes a temporary blanket exception. A patient encounter occurring at an ambulatory surgical center shall not be used to determine whether an eligible professional qualifies as a meaningful EHR user. This prohibition applies until a specified period has passed following a determination by the Department of Health and Human Services that certified EHR technology is applicable to that setting. Current law limits state reimbursement for DME under Medicaid to Medicare payment rates beginning January 1, 2019. The bill accelerates this limitation such that it begins October 1, 2018. 

Transparency and Accountability of Failed Exchanges Act

United States · United States Congress · 16 December 2015

Transparency and Accountability of Failed Exchanges Act This bill amends the Patient Protection and Affordable Care Act (PPACA) to require the Department of Health and Human Services, for certain states awarded a grant to establish a health insurance exchange, to report on how awarded amounts were used and rescind unobligated amounts. This applies to any state that terminates operation of its exchange or transfers operation to another entity. Such a state must provide to the General Services Administration any property acquired through the grant and refer matters involving fraud, waste, and abuse of funds issued pursuant to PPACA to the Department of Justice. Funds rescinded must be retained for federal budget deficit reduction.

Medicare and Medicaid Improvements and Adjustments Act of 2015

United States · United States Congress · 16 December 2015

Medicare and Medicaid Improvements and Adjustments Act of 2015 This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify payment rules and other provisions related to the Medicare and Medicaid programs. The bill includes off-campus outpatient department (OPD) services in Medicare's prospective payment system (in which predetermined amounts form the basis of payment) with respect to departments that are under development. The existing Medicare payment adjustment for cancer hospitals shall apply to off-campus OPDs. The bill temporarily prohibits specified Medicare payment adjustments related to competitive acquisition programs for certain wheelchair accessories. In addition, the bill modifies provisions related to: (1) reimbursement under Medicare for certain drugs furnished through durable medical equipment (DME), (2) Medicare payment rules for certain radiation therapy services, and (3) the treatment of Medicaid supplemental needs trusts. The bill expands criminal penalties and civil monetary penalties for certain acts involving federal health care programs. With respect to negative Medicare payment adjustments for physicians and hospitals that fail to comply with certain requirements related to electronic health records (EHR), the bill authorizes a temporary blanket exception. A patient encounter occurring at an ambulatory surgical center shall not be used to determine whether an eligible professional qualifies as a meaningful EHR user. This prohibition applies until a specified period has passed following a determination by the Department of Health and Human Services that certified EHR technology is applicable to that setting. Current law limits state reimbursement for DME under Medicaid to Medicare payment rates beginning January 1, 2019. The bill accelerates this limitation such that it begins October 1, 2018. 

Nurse and Health Care Worker Protection Act of 2015

United States · United States Congress · 16 December 2015

Nurse and Health Care Worker Protection Act of 2015 This bill requires the Department of Labor to establish a standard on safe patient handling, mobility, and injury prevention to prevent musculoskeletal disorders for health care workers. The standard must require the use of engineering and safety controls to handle patients. The standard must require health care employers to: (1) develop and implement a safe patient handling, mobility, and injury prevention program; (2) train their workers on safe patient handling, mobility, and injury prevention; and (3) post a notice that explains the standard, procedures to report patient handling-related injuries, and workers' rights under this Act. Labor must conduct unscheduled inspections to ensure compliance with the standard. This bill amends title XVIII (Medicare) of the Social Security Act to apply the standard to hospitals receiving Medicare funds.

Servicemember Higher Education Protection Act

United States · United States Congress · 15 December 2015

Servicemember Higher Education Protection Act This bill amends the Higher Education Act of 1965 to modify provisions related to student loans for members of the military and their spouses. The Department of Education (ED) shall make available a simplified disclosure and enrollment form for student loan borrowers who are performing eligible military service. The bill establishes, within the office of the Student Loan Ombudsman, a military and veteran point of contact. The bill modifies processes for determining disability with respect to discharging a borrower's student loans. A borrower whose loan is discharged under these processes shall not be subject to certain reinstatement provisions. Under current law, borrowers serving on active duty are eligible for certain student loan interest subsidies and deferment. The bill extends such eligibility to borrowers performing other specified military service and their spouses. The bill specifies how lump sum payments made through eligible repayment programs shall be treated for purposes of determining a borrower's eligibility for public service loan forgiveness. Without requiring a request from the borrower, ED must ensure that certain student loan interest does not accrue for an eligible military borrower serving in an area of hostilities. With respect to the National Student Loan Data System, ED must: (1) integrate certain data related to the military and veteran status of borrowers, and (2) include information regarding Public Health Service loans. ED shall use specified information to ensure that an active duty borrower is not charged interest in excess of a maximum rate on certain student loans. The bill limits the allowable interest rate on certain student loan debt incurred during military service for the purpose of consolidating or refinancing student loans incurred before service. The bill establishes a working group to improve resources available from the Department of Defense's tuition assistance programs.

Guard and Reserve Equal Access to Health Act

United States · United States Congress · 15 December 2015

Guard and Reserve Equal Access to Health Act This bill directs the military department concerned to provide a physical examination to each requesting member of a reserve component who will not otherwise receive one through that department. The military department concerned shall: (1) provide such examination during the 90-day period before such member's scheduled date of separation, and (2) give the member a record of the examination. A member shall not be entitled to transitional health care benefits through his or her department solely by reason of being given such examination.

Primary Care Physician Reentry Act of 2015

United States · United States Congress · 10 December 2015

Primary Care Physician Reentry Act of 2015 This bill directs the Department of Health and Human Services (HHS) to establish a demonstration program to facilitate physician reentry into primary care clinical practice. To be eligible to participate, a physician must agree to provide primary care at a health center for at least two years. Grantees must assist reentering physicians by providing training, paying credentialing and other necessary fees, paying salaries, and providing loan repayment and other financial assistance. HHS must: (1) assess the need for additional primary care physicians, (2) develop a directory of programs that help physicians reenter clinical practice, (3) disseminate evaluation tools to measure the core competencies of physicians reentering clinical practice, and (4) assist regulatory and credentialing authorities to structure requirements for reentering physicians that ensure patient safety while addressing the burdens on those physicians. This bill limits civil liability for physicians participating in a reentry project.

Medicare Advantage Bill of Rights Act of 2015

United States · United States Congress · 10 December 2015

Medicare Advantage Bill of Rights Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to establish limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required. An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements. The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required. Sanctions for noncompliance with the bill's requirements apply.

Community-Based Independence for Seniors Act of 2015

United States · United States Congress · 10 December 2015

Community-Based Independence for Seniors Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to establish a Community-Based Institutional Special Needs Plan demonstration program through which up to five eligible Medicare Advantage (MA) organizations shall provide home and community-based care to eligible Medicare beneficiaries. For purposes of the demonstration program, an eligible Medicare beneficiary is ineligible for Medicaid and unable to perform two or more activities of daily living. The Centers for Medicare & Medicaid Services (CMS) shall establish payment rates for eligible MA plans under the demonstration program. Such payment rates are capped but shall be in addition to payments otherwise made to MA organizations with respect to such plans. CMS shall also: (1) help to educate eligible Medicare beneficiaries on the availability of the program, and (2) provide for program evaluation by an independent third party.

Minority Diabetes Initiative Act

United States · United States Congress · 10 December 2015

Minority Diabetes Initiative Act This bill amends the Public Health Service Act to allow the Department of Health and Human Services (HHS) to make grants to public and nonprofit private health care providers to provide treatment for diabetes in minority communities. HHS must ensure that these grants cover a variety of diabetes-related health care services, including routine care for diabetic patients, public education on diabetes prevention and control, eye care, foot care, and treatment for kidney disease and other complications of diabetes.

Medicare Advantage Bill of Rights Act of 2015

United States · United States Congress · 10 December 2015

Medicare Advantage Bill of Rights Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to establish limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required. An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements. The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required. Sanctions for noncompliance with the bill's requirements apply.

Preserve Access to Medicare Rural Home Health Services Act of 2015

United States · United States Congress · 10 December 2015

Preserve Access to Medicare Rural Home Health Services Act of 2015 This bill amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend through 2021 the rural add-on, which is a payment increase for Medicare home health services furnished to patients in rural areas. The bill also amends title XVIII (Medicare) of the Social Security Act to lower, for FY2018-FY2022, the annual ceiling on the home health outlier adjustment, which is a payment increase for home health services furnished to the costliest Medicare beneficiaries, from 2.5% to 2.25% of the total Medicare payments projected to be made under the prospective payment system for home health services. (Under the Medicare prospective payment system, payment is made according to a predetermined, fixed amount.)

Reciprocity Ensures Streamlined Use of Lifesaving Treatments Act of 2015

United States · United States Congress · 10 December 2015

Reciprocity Ensures Streamlined Use of Lifesaving Treatments Act of 2015 This bill amends the Federal Food, Drug, and Cosmetic Act to establish a reciprocal marketing approval process that allows for the sale of a drug, biological product, or medical device that has not been approved by the Food and Drug Administration (FDA) if the product is approved for sale in another country. For a product to be granted reciprocal marketing approval, the product's sponsor must submit a request to the FDA that demonstrates: (1) the product may be sold in at least one country from a specified list of countries, (2) the FDA and listed countries have not withdrawn approval of the product because of safety or effectiveness concerns, and (3) there is a public health or unmet medical need for the product. The FDA may: (1) require postmarket studies of a product granted reciprocal marketing approval, or (2) decline to approve a product that is not safe and effective. The FDA must grant or decline reciprocal marketing approval not later than 30 days after receiving a request. During that period, the FDA and product sponsor must negotiate and finalize product labeling and, for a medical device, classify the device. Congress may pass a joint resolution to grant reciprocal marketing approval to a product that the FDA declines to approve through this process. User fees apply to requests for reciprocal marketing approval. The FDA must encourage the sponsors of potentially eligible products to request reciprocal marketing approval.

To amend the Internal Revenue Code of 1986 to determine eligibility for health insurance subsidies without regard to amounts included in income by reason of conversion to a Roth IRA.

United States · United States Congress · 10 December 2015

This bill amends the Internal Revenue Code to exclude any amount includible in gross income for converting to a Roth Individual Retirement Account from the calculation of adjusted gross income used to determine eligibility for, and the amount of, the tax credit for health care insurance premium assistance.

EXAMINING LEGISLATION TO IMPROVE HEALTH CARE AND TREATMENT

United States · United States House of Representatives · 9 December 2015

Medicare Fair Drug Pricing Act of 2015

United States · United States Congress · 9 December 2015

Medicare Fair Drug Pricing Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare & Medicaid Services (CMS) to negotiate with drug manufacturers in determining the price that may be charged for prescription drugs under the Medicare prescription drug benefit. Under current law, CMS may not interfere with negotiations between drug manufacturers and prescription drug plan (PDP) sponsors. The bill creates an exception to this prohibition with respect to specified drugs that: (1) are single-source or biological, (2) are not both manufactured by more than two drug manufacturers and manufactured by at least one manufacturer as a generic drug, and (3) meet other specified requirements. CMS must promulgate regulations regarding the identification of such drugs. With respect to these drugs, CMS shall negotiate the price that may be charged to PDP sponsors and Medicare Advantage (MA) organizations for Medicare and MA enrollees. The bill establishes processes for negotiation and price determination in the initial plan year and subsequent plan years. A manufacturer must participate in the negotiation process as a condition of coverage under the Medicare prescription drug benefit.

Restoring the Partnership for County Health Care Costs Act of 2015

United States · United States Congress · 9 December 2015

Restoring the Partnership for County Health Care Costs Act of 2015 This bill amends titles XVI (Supplemental Security Income), XVIII (Medicare), XIX (Medicaid), and XXI (Children's Health Insurance Program) (CHIP) to allow an otherwise eligible individual who is in custody pending charges to receive SSI, Medicare, Medicaid, or 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. 

Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2015

United States · United States Congress · 9 December 2015

Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to revise requirements related the approval of intensive cardiac rehabilitation programs by the Centers for Medicare & Medicaid Services (CMS) for purposes of Medicare coverage. To be approved by CMS as an intensive cardiac rehabilitation program under current law, a program must show that it: (1) positively affected the progression of coronary heart disease or reduced the need for either coronary bypass surgery or percutaneous coronary interventions, and (2) accomplished a significant reduction in other specified health measures. The bill instead requires a program to show that it: (1) reversed the progression of coronary heart disease or reduced the need for coronary bypass surgery; and (2) accomplished, in addition to a significant reduction in other specified health measures, a significant increase in the measure of blood flow to the heart. The bill further requires a program to show, using research of its own program, that these measures were accomplished by lifestyle changes alone. The bill removes the specific requirement that such a program be "physician-supervised" but retains other existing requirements for program supervision. A program that was approved by CMS as an intensive cardiac rehabilitation program prior to August 1, 2015, shall be deemed to have met these requirements. To be eligible for an intensive cardiac rehabilitation program under current law, an individual must have had one of several specified conditions or interventions. The bill adds to the list of qualifying conditions: (1) stable, chronic heart failure; and (2) any additional condition that CMS determines shall be covered under such a program.

Puerto Rico Assistance Act of 2015

United States · United States Congress · 9 December 2015

Puerto Rico Assistance Act of 2015 TITLE I--TAXES The bill provides for a reduction in employment and self-employment tax rates for qualified residents of Puerto Rico, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands during a payroll tax holiday period beginning after December 31, 2015, and ending before January 1, 2021. TITLE II--PUBLIC PENSIONS The bill requires reports on: (1) the financial condition of Puerto Rico public pension plans, and (2) state and local government employee pension benefit plans. The bill amends the Internal Revenue Code to provide for annuity accumulation retirement plans for state and local government employees beginning after 2015. TITLE III--PUERTO RICO FINANCIAL RESPONSIBILITY AND MANAGEMENT ASSISTANCE AUTHORITY The bill establishes the Puerto Rico Financial Responsibility and Management Assistance Authority to assist the Commonwealth government of Puerto Rico and its public corporations in achieving financial stability. The Authority shall initiate a control period for either the Commonwealth government or a public corporation by certifying that either such entity: (1) does not have sufficient revenue to meet is debt obligations, (2) has defaulted on a loan or other financial obligation, (3) is unable to meet payroll, (4) has a cash deficit, or (5) fails to make required pension payments. For each year in which the Commonwealth government or a public corporation is in a control period, the Governor of Puerto Rico or the emergency manager of a public corporation shall develop and submit to the Authority a financial plan and budget. A control period terminates when the Authority certifies that the Commonwealth government or its public corporations have adequate access to credit and have been solvent for a specified period. The bill sets forth standards to promote the financial stability of the Commonwealth government and its public corporations. The Authority may issue bonds at the request of the governor and pursuant to an act of the Legislative Assembly to raise revenue for the functioning of the Commonwealth government. The bill establishes the Office of the Chief Financial Officer of Puerto Rico. During a control period the Chief Financial Officer shall assist the governor in preparing financial plans and budgets and shall oversee other financial operations of the Commonwealth government. TITLE IV--ADDITIONAL REPORTS AND STUDIES The bill requires: (1) a report on the exclusion of U.S. territories from participation in health care exchanges, and (2) recommendations on the manner in which the federal government should more equitably allocate resources across U.S. territories. TITLE V--TRANSITION ASSISTANCE The bill authorizes appropriations, to remain available through FY2016, for use by the Authority to assist the transition of Puerto Rico to financial, fiscal, economic, and health care stability, the cost of which shall be offset by reductions in funding for the Prevention and Public Health Fund. TITLE VI--TECHNICAL ASSISTANCE The Department of the Treasury must provide technical assistance to U.S. territories (including Puerto Rico) for improved accounting and disclosure practices.

Condemning violence that targets healthcare for women.

United States · United States Congress · 8 December 2015

Denounces the attacks on health care centers for women, providers of health care for women, and patients. Affirms that all women have the right to access reproductive health care services without fear of violence, intimidation, or harassment.

PACT Act of 2015

United States · United States Congress · 8 December 2015

Protecting Access through Competitive-pricing Transition Act of 2015 or the PACT Act of 2015 This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify provisions relating to payment for durable medical equipment (DME) under the Medicare and Medicaid programs. (DME includes certain medically necessary equipment such as walkers, wheelchairs, and hospital beds.) With respect to DME furnished in areas that are not competitive acquisition areas, current regulations require the Centers for Medicare & Medicaid (CMS) to phase in, over a two-year period, Medicare payment adjustments using information from competitive acquisition programs. (Through such programs, payment amounts for each area are determined based on competitive bids submitted by suppliers, rather than according to an established fee schedule.) The bill codifies this requirement and specifies that CMS shall adjust fee schedule amounts to the lesser of: (1) a specified percentage of the regional amount; and (2) the amount that would otherwise be determined according to the fee schedule, with specified adjustments. In determining Medicare payment adjustments for areas that are not competitive acquisition areas, CMS shall solicit stakeholder input and take into account several specified factors. CMS may not accept a bid under the competitive acquisition program unless the bidder: (1) meets applicable state licensure requirements; and (2) has submitted a cash deposit as a bond, as specified by the bill. CMS must establish a six-year market pricing demonstration project, under which auctions are conducted in eligible areas for the furnishing of market-priced DME items and services. The bill establishes project requirements related to auction design, contract terms, transparency, and monitoring.

Lymphedema Treatment Act

United States · United States Congress · 8 December 2015

Lymphedema Treatment Act This bill amends title XVIII (Medicare) of the Social Security Act to cover certain lymphedema compression treatment items as durable medical equipment under Medicare. (Lymphedema is a condition of localized fluid retention and tissue swelling that is caused when the lymphatic system is damaged or blocked.)

AFIRM Act

United States · United States Congress · 8 December 2015

Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 or the AFIRM Act This bill amends title XVIII (Medicare) of the Social Security Act to require the Department of Health and Human Services (HHS) to establish, within the Office of Medicare Hearings and Appeals, decision-making officials to be known as Medicare magistrates. The bill extends training requirements for Administrative Law Judges to Medicare magistrates and establishes additional training for both types of adjudicator. The bill also requires HHS to provide for the annual transfer, from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Insurance Trust Fund, of specified additional funding for Medicare hearings and appeals. HHS shall: establish a process for the referral of cases in which there is a credible suspicion of fraudulent activity to relevant specified agencies; annually publish on its website specified data regarding Medicare appeals; implement a process for identifying inconsistent interpretations of policies in Medicare appeals; establish an optional alternative dispute resolution process for redeterminations and reconsiderations; create guidelines for reviewing claims for payment submitted by providers; designate a point of contact to oversee and undertake several Medicare program integrity initiatives; establish a secure system through which a provider may track the status of a claim for payment that is being audited or processed as an appeal; appoint a Medicare Reviews and Appeals Ombudsman; and establish a compliance incentive program applicable to Medicare review contractors as well as providers. The bill makes several other revisions to Medicare appeals provisions.

Medicare Home Health Flexibility Act of 2015

United States · United States Congress · 8 December 2015

Medicare Home Health Flexibility Act of 2015 This bill establishes circumstances under which an occupational therapist may conduct the initial assessment visit for an individual who is eligible for home health services under Medicare. Specifically, an occupational therapist may conduct the assessment if the physician's referral order does not include skilled nursing care but does include: (1) occupational therapy, and (2) physical therapy or speech language pathology.

[H.A.S.C. No. 114-72] STAKEHOLDER VIEWS ON MILITARY HEALTH CARE

United States · United States House of Representatives · 3 December 2015

Expressing support for health and wellness coaches and "National Health and Wellness Coach Recognition Week".

United States · United States Congress · 3 December 2015

Expresses support for the designation of National Health and Wellness Coach Recognition Week and for the efforts of health and wellness coaches.

Securing Fairness in Regulatory Timing Act of 2015

United States · United States Congress · 3 December 2015

Securing Fairness in Regulatory Timing Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to extend from 45 days to 60 days the annual notice period for the announcement of payment rates under Medicare Advantage (MA). MA organizations shall have at least 30 days to comment on proposed changes.

Medicare Advantage Coverage Transparency Act of 2015

United States · United States Congress · 3 December 2015

Medicare Advantage Coverage Transparency Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to direct the Centers for Medicare and Medicaid to report annually to specified congressional committees on Medicare Advantage enrollment data.

A resolution condemning violence that targets healthcare for women.

United States · United States Congress · 3 December 2015

Denounces the attacks on health care centers for women, providers of health care for women, and patients. Affirms that all women have the right to access reproductive health care services without fear of violence, intimidation, or harassment.

Territories Medicare Prescription Drug Assistance Equity Act of 2015

United States · United States Congress · 2 December 2015

Territories Medicare Prescription Drug Assistance Equity Act of 2015 This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to make certain income-based subsidies available to Medicare prescription drug program beneficiaries who reside in Puerto Rico or another U.S. territory and are otherwise eligible. Current law makes such beneficiaries ineligible for premium and cost-sharing subsidies, but establishes a process for U.S. territories to apply for financial assistance with respect to the provision of Medicare prescription drugs. The bill retains a process for U.S. territories to apply for such assistance, but alters the formula by which the amount of assistance is calculated. Specifically, the bill phases in modifications to the formula that more closely align how assistance is calculated for U.S. territories with how it is calculated for the 50 states and the District of Columbia.

Telehealth Innovation and Improvement Act of 2015

United States · United States Congress · 2 December 2015

Telehealth Innovation and Improvement Act of 2015 This bill amends titles XI (General Provisions) and XVIII (Medicare) of the Social Security Act to establish: (1) a telehealth service model, and (2) Medicare payment rules with respect to certain services tested under the model. The Centers for Medicare & Medicaid Services (CMS) shall test Medicare coverage of expanded telehealth services, as defined by the bill, in conjunction with existing models that test the use of accountable care organizations, bundled payments, and other coordinated care models under Medicare. CMS must: (1) establish a methodology for determining the amounts of payment for such services, and (2) provide for evaluations of the service model by an independent entity. CMS shall expand the application of a service tested under the model if: (1) the required evaluation demonstrates that the service either reduced Medicare spending without reducing the quality of care or improved the quality of care without increasing spending, and (2) the Chief Actuary of CMS certifies that such expansion would reduce net program spending. A service that meets these requirements is defined by the bill as a "certified enhanced telehealth service." Medicare payment for a certified enhanced telehealth service shall equal 80% of the lesser of: (1) the actual charge for the service, or (2) the amount determined using the payment methodology established under the test model. CMS shall pay for such services without regard to a Medicare beneficiary's location or area of residence.

Educating to Prevent Eating Disorders Act of 2015

United States · United States Congress · 2 December 2015

Educating to Prevent Eating Disorders Act of 2015 This bill amends the Public Health Service Act to permit the Agency for Healthcare Research and Quality to establish a pilot program to provide students with interventions for eating disorders. Under this pilot program, grants must be awarded to schools that serve students in grades 6-8 and need a nurse trained in recognizing and responding to eating disorders. Schools must use these grants to develop best practices for health care providers to assess, recognize, and respond to students with eating disorders and to hire a health care provider to: (1) follow these best practices, (2) provide information and seminars on eating disorders to teachers and parents, and (3) otherwise serve as a full time health care provider for the school.

Cardiac Arrest Survival Act of 2015

United States · United States Congress · 2 December 2015

Cardiac Arrest Survival Act of 2015 This bill amends the Public Health Service Act to expand immunity from civil liability related to automated external defibrillator devices (AEDs), including by giving immunity to: (1) a person who owns, occupies, or manages the premises from which an AED is taken or at which an AED is used; and (2) the owner of an AED for any harm resulting from the use of the AED, unless the harm was caused by the failure of the owner to properly maintain the AED. This immunity applies regardless of whether: (1) the AED is marked with cautionary signage or registered with any government; or (2) the person who used the AED complied with signage, had received training on use of the AED, or was assisted or supervised, including by a licensed physician.

Telehealth Innovation and Improvement Act of 2015

United States · United States Congress · 2 December 2015

Telehealth Innovation and Improvement Act of 2015 This bill amends titles XI (General Provisions) and XVIII (Medicare) of the Social Security Act to establish: (1) a telehealth service model, and (2) Medicare payment rules with respect to certain services tested under the model. The Centers for Medicare & Medicaid Services (CMS) shall test Medicare coverage of expanded telehealth services, as defined by the bill, in conjunction with existing models that test the use of accountable care organizations, bundled payments, and other coordinated care models under Medicare. CMS must: (1) establish a methodology for determining the amounts of payment for such services, and (2) provide for evaluations of the service model by an independent entity. CMS shall expand the application of a service tested under the model if: (1) the required evaluation demonstrates that the service either reduced Medicare spending without reducing the quality of care or improved the quality of care without increasing spending, and (2) the Chief Actuary of CMS certifies that such expansion would reduce net program spending. A service that meets these requirements is defined by the bill as a "certified enhanced telehealth service." Medicare payment for a certified enhanced telehealth service shall equal 80% of the lesser of: (1) the actual charge for the service, or (2) the amount determined using the payment methodology established under the test model. CMS shall pay for such services without regard to a Medicare beneficiary's location or area of residence.

Territories Medicare Prescription Drug Assistance Equity Act of 2015

United States · United States Congress · 2 December 2015

Territories Medicare Prescription Drug Assistance Equity Act of 2015 This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to make certain subsidies available to Medicare prescription drug program beneficiaries who reside in Puerto Rico or another U.S. territory. Current law makes such beneficiaries ineligible for premium and cost-sharing subsidies, but establishes a process for U.S. territories to apply for financial assistance with respect to the provision of Medicare prescription drugs. The bill eliminates this process and makes the subsidies available to beneficiaries who reside in a U.S. territory and are otherwise eligible.

A resolution designating December 3, 2015, as "National Phenylketonuria Awareness Day".

United States · United States Congress · 2 December 2015

Designates December 3, 2015, as National Phenylketonuria Awareness Day. (Phenylketonuria or PKU is a rare, inherited metabolic disorder that can cause intellectual disability and other neurological problems.)

LIFETIME Act

United States · United States Congress · 1 December 2015

Living Independently for Extended Time Act or the LIFETIME Act This bill requires the Department of Health and Human Services to award grants to enable eligible states to develop innovative programs to meet the unique need for long-term services and supports in the state.