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I
117TH CONGRESS
1ST SESSION H. R. 4074
To amend title XVIII of the Social Security Act to expand the availability
of supplemental benefits to certain Medicare Advantage enrollees.
IN THE HOUSE OF REPRESENTATIVES
JUNE 23, 2021
Mr. BILIRAKIS 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 expand
the availability of supplemental benefits to certain Medi-
care Advantage enrollees.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Addressing Social De-
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terminants in Medicare Advantage Act of 2021’’.
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•HR 4074 IH
SEC. 2. EXPANDING THE AVAILABILITY OF SUPPLEMENTAL
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BENEFITS TO CERTAIN MEDICARE ADVAN-
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TAGE ENROLLEES.
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(a) IN GENERAL.—Section 1852(a)(3)(D) of the So-
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cial Security Act (42 U.S.C. 1395w–22(a)(3)(D)) is
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amended—
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(1) in the header, by striking ‘‘CHRONICALLY
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ILL’’ and inserting ‘‘CERTAIN’’;
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(2) in clauses (i) and (ii), by striking ‘‘chron-
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ically ill’’ each place such term appears and insert-
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ing ‘‘specified’’ in each such place; and
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(3) in clause (iii), by amending such clause to
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read as follows:
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‘‘(iii)
SPECIFIED
ENROLLEE
DE-
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FINED.—In this subparagraph, the term
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‘specified enrollee’ means an enrollee in an
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MA plan that—
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‘‘(I) the Secretary determines—
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‘‘(aa) has one or more co-
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morbid and medically complex
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chronic conditions that is life
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threatening or significantly limits
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the overall health or function of
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the enrollee;
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•HR 4074 IH
‘‘(bb) has a high risk of hos-
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pitalization
or
other
adverse
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health outcomes; and
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‘‘(cc) requires intensive care
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coordination;
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‘‘(II) is a low-income enrollee (as
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specified by the Secretary); or
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‘‘(III) meets any other criterion
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determined appropriate by the Sec-
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retary, such as criteria relating to so-
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cial and socioeconomic risk.’’.
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(b) EFFECTIVE DATE.—The amendments made by
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subsection (a) shall apply with respect to plan years begin-
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ning on or after January 1, 2023.
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Æ
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