Medicare and Medicaid Improvements and Adjustments Act of 2015

Summary

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. 

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

1. 16 December 2015

   Introduced

   Read twice and referred to the Committee on Finance.

   Source: IntroReferral

2. 16 December 2015

   Introduced

   Introduced in Senate

   Source: IntroReferral

Votes

No vote records are attached yet.

Versions

• Introduced in Senate · 16 December 2015 · Official file

Documents

3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 16 December 2015

  ViewDownloadOpen at official source

• Introduced in Senate (PDF)

  Introduced in Senate · EN · 16 December 2015

  ViewDownloadOpen at official source

• Introduced in Senate

  summary · EN · 16 December 2015

  Open at official source

Sponsors

• Ron Wyden · D · Sponsor
• Maria Cantwell · D · Cosponsor
• Patty Murray · D · Cosponsor
• · ssfi00 · Standing

Related records

• related to → Special Needs Trust Fairness and Medicaid Improvement Act
• related to ← Medicare and Medicaid Improvements and Adjustments Act of 2015