Strengthening Healthcare Options for Vulnerable Populations Act
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HR 4484 — Strengthening Healthcare Options for Vulnerable Populations Act
Last action — Referred to the Subcommittee on Health.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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✓In Committee
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Died in session
This bill died with 113th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Strengthening Healthcare Options for Vulnerable Populations Act - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to extend permanently the authorization for certain Medicare Advantage (MA) Dual Special Needs Plans (D-SNPs). Requires MA D-SNPs by December 31, 2018, to be fully integrated, in accordance with state law, with capitated contracts with states for any benefits under SSA title XIX (Medicaid), including long-term care and behavioral health. Directs the Secretary of Health and Human Services (HHS) to develop a clearly defined role for state Medicaid agencies in contracting and oversight of plans. Directs the Secretary, in implementing requirements for the payment of Medicare+Choice organizations, to take steps necessary to ensure that the quality rating for a D-SNP: (1) does not disadvantage a plan that enrolls full-benefit dual (Medicare- and Medicaid-) eligible individuals, qualified Medicare beneficiaries, and individuals with complex health care needs; and (2) accounts for differences in socioeconomic and demographic characteristics of enrollees of such a plan that result in significant variation in health outcomes. Allows the Secretary to increase temporarily the quality rating that a specialized MA plan would otherwise receive under certain circumstances. Directs the Comptroller General (GAO) to report on steps taken for improving health outcomes, cost controls, and beneficiary satisfaction. Amends the Patient Protection and Affordable Care Act to designate the Federal Coordinated Health Care Office (FCHCO) as the dedicated point of contact within the Centers for Medicare & Medicaid Services to assist states with ongoing D-SNP administration issues. Allows the Secretary, through the FCHCO, to waive applicable Medicare requirements to promote the integration, alignment, and delivery of items and services under the Medicare program and the Medicaid program, with respect to dual eligible individuals and to ensure the seamless delivery of patient-centered services across the continuum of care with resect to such individuals. Requires D-SNPs to provide coverage during the appeals process with respect to dispute resolution for claims. Directs the Secretary to establish a streamlined process for dispute resolution for claims and appeals, with respect to items and services furnished to special needs individuals, to align the Medicare program process with the one under the Medicaid program. Amends SSA title XI to require the Secretary to report to Congress on the Integrated Data Repository and the One Program Integrity System.
Bill Text
We don't have the full text on file for this bill yet.
Read HR 4484 on the official United States source →Action History
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Referred to the Subcommittee on Health.
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Referred to House Energy and Commerce
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Referred to House Ways and Means
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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.
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Sponsor introductory remarks on measure. (CR E571)
Sponsors
- Krysten Sinema · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HR 4484 do?
- Strengthening Healthcare Options for Vulnerable Populations Act - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to extend permanently the authorization for certain Medicare Advantage (MA) Dual Special Needs Plans (D-SNPs). Requires MA D-SNPs by December 31, 2018, to be fully integrated, in accordance with state law, with capitated contracts with states for any benefits under SSA title XIX (Medicaid), including long-term care and behavioral health. Directs the Secretary of Health and Human Services (HHS) to develop a clearly defined role for state Medicaid agencies in contracting and oversight of plans. Directs the Secretary, in implementing requirements for the payment of Medicare+Choice organizations, to take steps necessary to ensure that the quality rating for a D-SNP: (1) does not disadvantage a plan that enrolls full-benefit dual (Medicare- and Medicaid-) eligible individuals, qualified Medicare beneficiaries, and individuals with complex health care needs; and (2) accounts for differences in socioeconomic and demographic characteristics of enrollees of such a plan that result in significant variation in health outcomes. Allows the Secretary to increase temporarily the quality rating that a specialized MA plan would otherwise receive under certain circumstances. Directs the Comptroller General (GAO) to report on steps taken for improving health outcomes, cost controls, and beneficiary satisfaction. Amends the Patient Protection and Affordable Care Act to designate the Federal Coordinated Health Care Office (FCHCO) as the dedicated point of contact within the Centers for Medicare & Medicaid Services to assist states with ongoing D-SNP administration issues. Allows the Secretary, through the FCHCO, to waive applicable Medicare requirements to promote the integration, alignment, and delivery of items and services under the Medicare program and the Medicaid program, with respect to dual eligible individuals and to ensure the seamless delivery of patient-centered services across the continuum of care with resect to such individuals. Requires D-SNPs to provide coverage during the appeals process with respect to dispute resolution for claims. Directs the Secretary to establish a streamlined process for dispute resolution for claims and appeals, with respect to items and services furnished to special needs individuals, to align the Medicare program process with the one under the Medicaid program. Amends SSA title XI to require the Secretary to report to Congress on the Integrated Data Repository and the One Program Integrity System.
- Who sponsors HR 4484?
- HR 4484 is sponsored by Krysten Sinema (D).
- What is the current status of HR 4484?
- This bill died with 113th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track HR 4484?
- Track HR 4484 free on One Click Politics — get push/email alerts when it moves.
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