United States 114th Congress Status: Died 1 R cosponsors

HR 2581 — Preservation of Access for Seniors in Medicare Advantage Act of 2015

Last action — Placed on the Union Calendar, Calendar No. 117.

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  1. ✓
    Introduced
  2. Died in session

This bill died with 114th Congress. It reached “Introduced” 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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

Preservation of Access for Seniors in Medicare Advantage Act of 2015 (Sec. 2) This bill requires the Department of Health and Human Services (HHS) to establish a three-year demonstration program (extendable if necessary to four or five years) 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. (Sec. 3) 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. No unsolicited marketing or marketing materials may be sent to such an eligible individual during the continuous open enrollment and disenrollment period. (Sec. 4) 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. (Sec. 5) It is the sense of Congress that HHS: has incorrectly interpreted the determination of blended benchmark amounts as prohibiting any Medicare quality incentive payments with respect to MA plans that exceed the payment benchmark cap for the area served by those plans; and should immediately apply quality incentive payments with respect to such MA plans without regard to specified limits.

Bill Text

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Read HR 2581 on the official United States source →

Action History

  1. Placed on the Union Calendar, Calendar No. 117.

  2. Committee on Energy and Commerce discharged.

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

  4. Referred to the Subcommittee on Health.

  5. Referred to the Subcommittee on Health.

  6. Ordered to be Reported (Amended) by Voice Vote.

  7. Committee Consideration and Mark-up Session Held.

  8. Referred to House Energy and Commerce

  9. Referred to House Ways and Means

  10. 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.

  11. Introduced in House

Sponsors

Sponsorship breakdown

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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.

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"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.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
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Frequently asked questions

What does HR 2581 do?
Preservation of Access for Seniors in Medicare Advantage Act of 2015 (Sec. 2) This bill requires the Department of Health and Human Services (HHS) to establish a three-year demonstration program (extendable if necessary to four or five years) 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. (Sec. 3) 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. No unsolicited marketing or marketing materials may be sent to such an eligible individual during the continuous open enrollment and disenrollment period. (Sec. 4) 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. (Sec. 5) It is the sense of Congress that HHS: has incorrectly interpreted the determination of blended benchmark amounts as prohibiting any Medicare quality incentive payments with respect to MA plans that exceed the payment benchmark cap for the area served by those plans; and should immediately apply quality incentive payments with respect to such MA plans without regard to specified limits.
Who sponsors HR 2581?
HR 2581 is sponsored by Kevin Brady (R).
What is the current status of HR 2581?
This bill died with 114th Congress. It reached “Introduced” 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 2581?
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