SAVE Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 2080 To amend title XVIII of the Social Security Act to provide for temporary coverage of certain transportation services for certain individuals under the Medicare program, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 19, 2021 Mr. BISHOP of Georgia (for himself, Mr. CARTER of Georgia, Mr. CA´RDENAS, Mr. GRIFFITH, Mr. GRIJALVA, Ms. PRESSLEY, Mr. COHEN, Mr. LEVIN of California, Mr. CARBAJAL, and Ms. SEWELL) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be sub- sequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide for temporary coverage of certain transportation services for certain individuals under the Medicare program, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Senior Access to Vac- 4 cines Ensured Act of 2021’’ or the ‘‘SAVE Act of 2021’’. 5 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 2080 IH SEC. 2. FINDINGS. 1 Congress finds the following: 2 (1) The Kaiser Family Foundation reported 3 that only about 12 percent of Medicare beneficiaries 4 are full Medicare-Medicaid dual eligibles and, thus, 5 have Medicaid coverage for nonemergency medical 6 transportation (NEMT) to access COVID–19 vac- 7 cination appointments and other health care ap- 8 pointments. According to the Commonwealth Fund, 9 although 45 percent of Medicare beneficiaries have 10 incomes lower than 200 percent of the federal pov- 11 erty level (FPL), which can limit their transpor- 12 tation options, Medicare does not currently cover 13 NEMT. 14 (2) Medicare beneficiaries over the age of 65, 15 according to the Centers for Disease Control, are 24 16 times more likely to die from COVID–19 than an 17 adult aged 25–54. 18 (3) A managed NEMT benefit that offers 19 scheduling and other assistance would improve bene- 20 ficiaries’ access to the COVID–19 vaccine. It also 21 would reduce Medicare expenditures by covering 22 more cost-effective alternatives and avoiding the 23 high cost of in-patient COVID–19 treatment. 24 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 2080 IH SEC. 3. COVERAGE OF MANAGED, NONEMERGENT TRANS- 1 PORTATION SERVICES FOR CERTAIN INDI- 2 VIDUALS. 3 Title XVIII of the Social Security Act (42 U.S.C. 4 1395 et seq.) is amended by adding at the end the fol- 5 lowing new section: 6 ‘‘SEC. 1899C. MANAGED, NONEMERGENT TRANSPORTATION 7 SERVICES BENEFIT PROGRAM. 8 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab- 9 lish a program to be known as the ‘Managed, Nonemer- 10 gent Transportation Services Benefit Program’ for pur- 11 poses of furnishing qualifying individuals not more than 12 2 round-trip managed, nonemergent transportation serv- 13 ices (as defined in subsection (c)) to COVID–19 vaccina- 14 tion sites (including community pharmacies) beginning 15 April 1, 2021, and ending on the last day of the emergency 16 period described in section 1135(g)(1)(B). 17 ‘‘(b) CONTRACT WITH QUALIFIED TRANSPORTATION 18 MANAGER.— 19 ‘‘(1) IN GENERAL.—For each medicare admin- 20 istrative contractor jurisdiction for a year (beginning 21 with 2021), the Secretary shall enter into a contract 22 with one qualified transportation manager for pur- 23 poses of arranging for the provision of managed, 24 nonemergent transportation services to qualifying in- 25 dividuals in such region. Such contract shall provide 26 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 2080 IH that payment be made by the Secretary for such 1 service on the basis of prepaid capitation payments 2 (taking into account the charge described in para- 3 graph (2)(E)). 4 ‘‘(2) SELECTION.—Not later than 30 days after 5 the date of the enactment of this section, notwith- 6 standing any other provision of law, the Secretary 7 shall award contracts described in paragraph (1) 8 through a competitive bidding process under which 9 the Secretary evaluates applicant entities based on 10 experience, past performance, references, available 11 resources, and cost for purposes of selecting quali- 12 fied transportation managers, with preference given 13 to applicants with prior satisfactory performance as 14 a transportation broker under a program described 15 in section 1902(a)(70). Not later than 15 days after 16 such date of enactment, the Secretary shall publish 17 guidance for prospective qualified transportation 18 managers. Such guidance shall include information 19 on how such manager may enter into a contract de- 20 scribed in this subsection and a description of terms 21 and conditions applicable to such managers with 22 such contracts. Such a manager shall meet the fol- 23 lowing requirements: 24 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 2080 IH ‘‘(A) The manager establishes procedures 1 meeting criteria established by the Secretary for 2 addressing beneficiary complaints and ensuring 3 network transportation providers are licensed 4 by the State for purposes of operating vehicles 5 and are competent and courteous. 6 ‘‘(B) The manager is subject to regular 7 audit and oversight by the State in which such 8 manager operates in order to ensure the quality 9 and timeliness of transportation services man- 10 aged and the adequacy of qualifying individuals’ 11 access to medical care and services. 12 ‘‘(C) The manager complies with all re- 13 quirements specified in the contract described 14 in paragraph (1). Such requirements shall in- 15 clude requirements related to— 16 ‘‘(i) reviews and evaluations to ensure 17 the quality, appropriateness, and timeliness 18 of such services arranged by such man- 19 ager; 20 ‘‘(ii) prohibitions on referrals and con- 21 flict of interest as the Secretary shall es- 22 tablish (based on the prohibitions on physi- 23 cian referrals under section 1877 and such 24 other prohibitions and requirements as the 25 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 2080 IH Secretary determines to be appropriate); 1 and 2 ‘‘(iii) the development and implemen- 3 tation of a corrective action plan to ad- 4 dress any contract deficiencies. 5 ‘‘(D) The manager establishes procedures 6 for determining an individual’s eligibility for 7 managed, nonemergent transportation services 8 under the program established under subsection 9 (a) using criteria established by the Secretary 10 under subsection (c)(3) and for scheduling and 11 organizing the furnishing of such services. 12 ‘‘(c) DEFINITION.—For purposes of this section: 13 ‘‘(1) MANAGED, NONEMERGENT TRANSPOR- 14 TATION SERVICES.—The term ‘managed, nonemer- 15 gent transportation services’ means the transpor- 16 tation of an individual by car, taxi, bus, or other 17 similar means (as specified by the Secretary) to a 18 provider or supplier of services where such individual 19 is to be furnished items or services payable under 20 this title. 21 ‘‘(2) QUALIFIED TRANSPORTATION MANAGER.— 22 The term ‘qualified transportation manager’ means 23 an entity that arranges, under contract with the 24 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 2080 IH Secretary, for the provision of managed, nonemer- 1 gent transportation services to qualifying individuals. 2 ‘‘(3) QUALIFYING INDIVIDUAL.—The term 3 ‘qualifying individual’ means an individual entitled 4 to benefits under part A who is not enrolled under 5 a Medicare Advantage plan under part C and who 6 is not a full-benefit dual eligible individual (as de- 7 fined in paragraph (4)) who has no readily-available 8 means of transportation (as determined by the Sec- 9 retary). In determining whether an individual has no 10 readily-available means of transportation for pur- 11 poses of the previous sentence, the Secretary shall 12 establish criteria similar to those used by States in 13 making such determinations under a non-emergency 14 medical transportation program under a State plan 15 under title XIX (or a waiver of such plan), such as 16 evaluating whether such individual— 17 ‘‘(A) has a driver’s license; 18 ‘‘(B) has a working vehicle available to 19 such individual at such individual’s residence; 20 ‘‘(C) is incapable of driving due to a med- 21 ical condition; and 22 ‘‘(D) has inadequate financial resources to 23 pay for transportation. 24 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 2080 IH ‘‘(4) FULL-BENEFIT DUAL ELIGIBLE INDI- 1 VIDUAL.— 2 ‘‘(A) IN GENERAL.—The term ‘full-benefit 3 dual eligible individual’ means for a State for a 4 month an individual who— 5 ‘‘(i) is entitled to benefits under part 6 A or enrolled under part B; and 7 ‘‘(ii) is determined eligible by the 8 State for medical assistance for full bene- 9 fits under title XIX for such month under 10 section 1902(a)(10)(A) or 1902(a)(10)(C), 11 by reason of section 1902(f), or under any 12 other category of eligibility for medical as- 13 sistance for full benefits under such title, 14 as determined by the Secretary. 15 ‘‘(B) TREATMENT OF MEDICALLY NEEDY 16 AND OTHER INDIVIDUALS REQUIRED TO SPEND 17 DOWN.—In applying paragraph (1) in the case 18 of an individual determined to be eligible by the 19 State for medical assistance under section 20 1902(a)(10)(C) or by reason of section 1902(f), 21 the individual shall be treated as meeting the 22 requirement of paragraph (1)(B) for any month 23 if such medical assistance is provided for in any 24 part of the month. 25 VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 2080 IH ‘‘(d) FUNDING.—The Secretary shall provide for the 1 transfer, from the Federal Supplementary Medical Insur- 2 ance Trust Fund under section 1841 to the Centers for 3 Medicare & Medicaid Services Program Management Ac- 4 count, of such sums as may be necessary for purposes of 5 carrying out this section. 6 ‘‘(e) CLARIFICATION.—The provisions of section 7 1862(a) shall not apply to payments made under a con- 8 tract described in subsection (b)(1).’’. 9 Æ VerDate Sep 11 2014 00:14 May 22, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H2080.IH H2080 pbinns on DSKJLVW7X2PROD with BILLS