Accountable Care in Rural America Act

I 117TH CONGRESS 1ST SESSION H. R. 3746 To amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program. IN THE HOUSE OF REPRESENTATIVES JUNE 8, 2021 Mr. ARRINGTON (for himself, Ms. SEWELL, Mr. DUNN, Mr. O’HALLERAN, Mr. GOODEN of Texas, Ms. DELBENE, Mr. BERA, and Mr. KELLY of Penn- sylvania) introduced the following bill; which was referred to the Com- mittee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speak- er, in each case for consideration of such provisions as fall within the ju- risdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Sav- ings Program. 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 ‘‘Accountable Care in 4 Rural America Act’’. 5 VerDate Sep 11 2014 20:13 Jun 27, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3746.IH H3746 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3746 IH SEC. 2. EXCLUSION OF MEDICARE FEE-FOR-SERVICE BENE- 1 FICIARIES ASSIGNED TO AN ACO FROM AS- 2 PECTS OF OTHER PAYMENT MODELS IN CER- 3 TAIN CIRCUMSTANCES INCLUDING DETER- 4 MINATION OF REGIONAL ADJUSTMENTS. 5 Section 1899(i)(3) of the Social Security Act (42 6 U.S.C. 1395jjj(i)(3)) is amended— 7 (1) in subparagraph (A), by striking ‘‘subpara- 8 graph (B)’’ and inserting ‘‘subparagraphs (B) and 9 (C)’’; and 10 (2) by adding at the end the following new sub- 11 paragraph: 12 ‘‘(C) EXCLUSION OF ASSIGNED BENE- 13 FICIARIES IN CERTAIN CIRCUMSTANCES IN- 14 CLUDING DETERMINATION OF REGIONAL AD- 15 JUSTMENTS.—For performance periods begin- 16 ning on or after the date of the enactment of 17 this subparagraph, in determining any shared 18 savings for any ACO under a model described 19 in this paragraph, the Secretary shall— 20 ‘‘(i) remove Medicare fee-for-service 21 beneficiaries who are assigned to that ACO 22 from the methodology for calculating re- 23 gional expenditures used to establish, up- 24 date, and adjust the benchmark expendi- 25 tures; and 26 VerDate Sep 11 2014 20:13 Jun 27, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3746.IH H3746 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3746 IH ‘‘(ii) otherwise ensure that no such 1 ACO is in a less favorable financial posi- 2 tion due to differences between the share 3 of Medicare fee-for-service beneficiaries as- 4 signed to the ACO of all such beneficiaries 5 in the counties an ACO operates in com- 6 pared to the share of such beneficiaries as- 7 signed to other ACOs.’’. 8 Æ VerDate Sep 11 2014 20:13 Jun 27, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6301 E:\BILLS\H3746.IH H3746 kjohnson on DSK79L0C42PROD with BILLS