What This Bill Does
This bill requires two government advisory groups (MedPAC and MACPAC) to work together every two years to review how Medicare and Medicaid serve people who qualify for both programs. These groups must analyze spending, usage and quality of care for these shared beneficiaries and recommend policy changes to improve coordination between the two programs.
Who It Affects
People who are eligible for both Medicare and Medicaid (called "dually eligible beneficiaries"), the Medicare Payment Advisory Commission (MedPAC), the Medicaid and CHIP Payment and Access Commission (MACPAC), and Congress.
Key Provisions
• Starting with the report due March 15, 2024, and every two years after that, MedPAC must work with MACPAC to jointly review spending, usage and financial performance under Medicare and Medicaid for people eligible for both programs. (Sec. 2(a)(1)(B)(i))
• These joint reviews must analyze trends in access to and quality of care provided to dually eligible beneficiaries. (Sec. 2(a)(1)(B)(i)(I))
• Each biennial report must include recommendations for changes to Medicare and Medicaid policy to ensure adequate access to care and improve alignment between the two programs in serving dually eligible beneficiaries. (Sec. 2(a)(1)(B)(i)(II)(bb))
• Each report must be submitted to the appropriate committees of Congress. (Sec. 2(a)(1)(B)(ii))
What Changes
MedPAC and MACPAC must now work together on coordinated biennial reviews and reports about people eligible for both Medicare and Medicaid, something not currently required by law.
Important Definitions
"Dually eligible beneficiaries" means individuals who qualify for both Medicare and Medicaid benefits.
Effective Date
The first coordinated review and report is due March 15, 2024. (Sec. 2(a)(1)(B)(i) and Sec. 2(a)(2)(C)(i))
II
118TH CONGRESS
1ST SESSION
S. 880
To require MedPAC and MACPAC to biennially conduct a coordinated review
and analysis of Medicare and Medicaid policy with respect to dually
eligible beneficiaries, and to jointly submit recommendations for policy
changes, and for other purposes.
IN THE SENATE OF THE UNITED STATES
MARCH 21, 2023
Mr. CASSIDY (for himself and Mr. CASEY) introduced the following bill; which
was read twice and referred to the Committee on Finance
A BILL
To require MedPAC and MACPAC to biennially conduct
a coordinated review and analysis of Medicare and Med-
icaid policy with respect to dually eligible beneficiaries,
and to jointly submit recommendations for policy
changes, 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 ‘‘Coordinating Dual Eli-
4
gible Recommendations Act’’.
5
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•S 880 IS
SEC. 2. COORDINATED MEDPAC AND MACPAC REVIEW AND
1
REPORT
REGARDING
DUALLY
ELIGIBLE
2
BENEFICIARIES.
3
(a) IN GENERAL.—
4
(1) MEDICARE.—Section 1805(b)(11) of the
5
Social Security Act (42 U.S.C. 1395b–6(b)(11)) is
6
amended—
7
(A) by striking ‘‘The Commission’’ and in-
8
serting the following:
9
‘‘(A) IN
GENERAL.—The Commission’’;
10
and
11
(B) by adding at the end the following:
12
‘‘(B) BIENNIAL
COORDINATED
REVIEW
13
AND JOINT REPORT ON POLICIES AFFECTING
14
DUALLY ELIGIBLE BENEFICIARIES.—
15
‘‘(i) IN
GENERAL.—Beginning with
16
the report for March 15, 2024, and bienni-
17
ally thereafter, the Commission shall co-
18
ordinate with MACPAC to jointly—
19
‘‘(I) review and analyze aggre-
20
gate trends in spending, utilization,
21
and
financial
performance
under
22
Medicare and Medicaid regarding ac-
23
cess to, and the quality of, care pro-
24
vided under such programs for dually
25
eligible beneficiaries; and
26
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•S 880 IS
‘‘(II) include as an appendix to
1
such report—
2
‘‘(aa)
analyses
of
such
3
trends; and
4
‘‘(bb) subject to paragraph
5
(10),
recommendations
for
6
changes to Medicare and Med-
7
icaid policy to ensure adequate
8
and efficient access to care to im-
9
prove and maintain the health
10
and functional status of dually el-
11
igible beneficiaries and to in-
12
crease the alignment of the Medi-
13
care and Medicaid programs in
14
serving such beneficiaries.
15
‘‘(ii) APPROPRIATE
COMMITTEES
OF
16
CONGRESS.—Each report required under
17
this subparagraph shall be submitted to
18
the appropriate committees of Congress.’’.
19
(2) MEDICAID.—Section 1900(b)(11) of the So-
20
cial Security Act (42 U.S.C. 1396(b)(11)) is amend-
21
ed by adding at the end the following:
22
‘‘(C) BIENNIAL
COORDINATED
REVIEW
23
AND JOINT REPORT ON POLICIES AFFECTING
24
DUALLY ELIGIBLE BENEFICIARIES.—
25
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•S 880 IS
‘‘(i) IN
GENERAL.—Beginning with
1
the report for March 15, 2024, and bienni-
2
ally thereafter, MACPAC shall coordinate
3
with the Medicare Payment Advisory Com-
4
mission established under section 1805 to
5
jointly—
6
‘‘(I) review and analyze aggre-
7
gate trends in spending, utilization,
8
and
financial
performance
under
9
Medicare and Medicaid regarding ac-
10
cess to, and the quality of, care pro-
11
vided under such programs for dually
12
eligible individuals; and
13
‘‘(II) include as an appendix to
14
such report—
15
‘‘(aa)
analyses
of
such
16
trends; and
17
‘‘(bb) subject to paragraph
18
(13),
recommendations
for
19
changes to Medicare and Med-
20
icaid policy to ensure adequate
21
and efficient access to care to im-
22
prove and maintain the health
23
and functional status of dually el-
24
igible beneficiaries and to in-
25
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•S 880 IS
crease the alignment of the Medi-
1
care and Medicaid programs in
2
serving such beneficiaries.
3
‘‘(ii) APPROPRIATE
COMMITTEES
OF
4
CONGRESS.—Each report required under
5
this subparagraph shall be submitted to
6
the appropriate committees of Congress
7
which, for purposes of this subparagraph,
8
shall include the Committee on Ways and
9
Means of the House of Representatives.’’.
10
(b) TECHNICAL AMENDMENTS.—
11
(1) MEDICARE.—Section 1805(b) of the Social
12
Security Act (42 U.S.C. 1395b–6(b)) is amended—
13
(A) in paragraph (6), by inserting ‘‘Energy
14
and’’ before ‘‘Commerce’’; and
15
(B) in paragraph (10), by striking ‘‘section
16
2081’’ and inserting ‘‘section 2602’’.
17
(2) MEDICAID.—Paragraph (13) of section
18
1900(b) of the Social Security Act (42 U.S.C.
19
1396(b)(13)) is amended by striking ‘‘section 2081’’
20
and inserting ‘‘section 2602’’.
21
Æ
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