Preservation of Access for Seniors in Medicare Advantage Act of 2015

Summary

Preservation of Access for Seniors in Medicare Advantage Act of 2015 This bill requires the Department of Health and Human Services (HHS) to establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage (MA) plans offered by MA organizations under part C (Medicare+Choice Program) of title XVIII (Medicare) of the Social Security Act (SSAct). "Value-based insurance design methodology" is one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by HHS. HHS may expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met. The annual 45-day period for disenrollment from MA plans to elect to receive benefits under the original Medicare fee-for-service program, and to elect coverage under part D (Voluntary Prescription Drug Benefit Program), shall end on December 31, 2015. Starting in 2016, a Medicare Advantage eligible individual, during the first three months of any year, may change a previous election to elect to receive benefits through the original Medicare fee-for-service program or an MA plan, and to elect coverage under part D. This continuous open enrollment and disenrollment period during the first three months of any year starting in 2016 shall apply with respect to a prescription drug plan only in the case of an individual who, previous to such change in enrollment, is enrolled in a MA plan. This bill also amends part B (Supplementary Medical Insurance) of SSAct title XVIII to revise requirements (in effect, changing payment methodologies from 95% of the Average Wholesale Price to the Average Sales Price plus six) for payments for infusion drugs and biologicals furnished through durable medical equipment on or after January 1, 2017.

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Timeline

1. 29 May 2015

   Introduced

   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.

   Source: IntroReferral

2. 29 May 2015

   Introduced

   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.

   Source: IntroReferral

3. 29 May 2015

   Introduced

   Introduced in House

   Source: IntroReferral

4. 29 May 2015

   Introduced

   Introduced in House

   Source: IntroReferral

5. 2 June 2015

   Reported

   Ordered to be Reported (Amended) by Voice Vote.

   Source: Committee

6. 2 June 2015

   Committee

   Committee Consideration and Mark-up Session Held.

   Source: Committee

7. 3 June 2015

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

8. 5 June 2015

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

9. 16 June 2015

   Calendars

   Placed on the Union Calendar, Calendar No. 117.

   Source: Calendars

10. 16 June 2015

    Discharge

    Committee on Energy and Commerce discharged.

    Source: Discharge

11. 16 June 2015

    Committee

    Committee on Energy and Commerce discharged.

    Source: Committee

12. 16 June 2015

    Reported

    Reported (Amended) by the Committee on Ways and Means. H. Rept. 114-161, Part I.

    Source: Committee

13. 16 June 2015

    Reported

    Reported (Amended) by the Committee on Ways and Means. H. Rept. 114-161, Part I.

    Source: Committee

Votes

No vote records are attached yet.

Versions

• Reported in House · 16 June 2015 · Official file
• Introduced in House · 29 May 2015 · Official file

Documents

6 official files

• Reported in House (text)

  Reported in House · EN · 16 June 2015

  ViewDownloadOpen at official source

• Reported in House (PDF)

  Reported in House · EN · 16 June 2015

  ViewDownloadOpen at official source

• Introduced in House (text)

  Introduced in House · EN · 29 May 2015

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 29 May 2015

  ViewDownloadOpen at official source

• Reported to House amended, Part I

  summary · EN · 29 May 2015

  Open at official source

• Introduced in House

  summary · EN · 29 May 2015

  Open at official source

Sponsors

• KEVIN BRADY · R · Sponsor
• · hsif00 · Standing
• · hswm00 · Standing

Related records

• related to → Medicare Beneficiary Preservation of Choice Act of 2015
• related to ← Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015