Senior citizens frustrated with the turmoil in Washington D.C., over both the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA), may find a breath of fresh air this week in Congressman Pat Tiberi. The representative from Ohio, and Chairman of the House Ways and Means Health Subcommittee, recently introduced two pieces of legislation that would protect vulnerable Medicare beneficiaries. One bill aims to reauthorize Special Needs Plans (SNPs), a part of Medicare Advantage, under the current Medicare system. The other bill seeks to create a smoother payment structure for home infusion services. Let’s take a look at both.
Reauthorizing Medicare SNPs
H.R. 3168 does not have an official name yet. Most importantly, however, it would improve the quality of care for seniors who live in poverty or have a chronic illness by renewing the Chronic Special Needs Plans (C-SNPs) and Dual Eligible Special Needs Plans (D-SNPs) for five years. The legislation would also make Institutional Special Needs Plans (I-SNPs) permanent for the first time in Medicare’s history. C-SNPs are for beneficiaries with severe or disabling chronic conditions, and may target a single condition or more than one. D-SNPs are for those of who have Medicare and Medicaid (a.k.a. dual-eligible). I-SNPs are for people living in an institution or who need nursing care at home.
Unlike the AHCA and BCRA, H.R. 3168 begins with bipartisanship. Co-sponsoring the legislation with Tiberi, a Republican, to extend and strengthen SNPs is Representative Sander Levin of Michigan, a Democrat who is a Ranking Member on the House Ways and Means Health Subcommittee. If you recognize Levin’s name, it’s because he introduced a bill earlier this month that would extend Medicare to cover medical care that addresses dental, vision, and hearing illnesses.
“SNPs offer targeted, coordinated care to some of the frailest and sickest beneficiaries in the Medicare program,” said Tiberi. “Our bipartisan legislation will provide the certainty these patients need to access the quality care they rely on over the long term. While Congress has routinely reauthorized SNPs every two to three years, this legislation puts the SNP program on a stronger and more permanent path. The main goals of this legislation are to increase transparency, incentivize and reward care coordination and efficiency, and improve quality and health outcomes for our most vulnerable seniors.”
“Special Needs Plans aim to improve care for certain Medicare beneficiaries, including those who are dually eligible for Medicare and Medicaid, as well as other vulnerable groups,” Levin added. “This legislation follows a number of recommendations from the Medicare Payment Advisory Commission to extend and reform these plans with the goal of coordinating care and improving quality for special needs populations.”
Read the bill in its entirety here
Home infusion services
The other bill Tiberi introduced this week is H.R. 3163. Its official name is the Medicare Part B Home Infusion Services Temporary Transitional Payment Act. Like the legislation to improve SNPs under Medicare, this legislation is also bipartisan. Joining Tiberi in sponsorship of this bill is Representative Bill Pascrell of New Jersey. The Medicare Part B Home Infusion Services Temporary Transitional Payment Act would create a new transitional payment structure for those who provide home infusion services before policies signed into law in the 21st Century Cures Act take effect in 2021.
“Congressman Bill Pascrell and I introduced this bipartisan legislation to protect access to infused medications for vulnerable beneficiaries,” said Tiberi. “It ensures that providers will receive necessary resources during the transition period until 2021 so that patients can continue to receive the home infusion therapies they need in the comfort of their homes.”
“I am pleased to introduce the Medicare Part B Home Infusion Services Temporary Transitional Payment Act with my friend Congressman Pat Tiberi,” added Pascrell. “This bill will help ease the transition to more accurate payments for home infusion drugs, ensuring that patients maintain appropriate access until Medicare implements a new home infusion nursing benefit in 2021.”
Read the bill in its entirety here
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