Chronic Care Management Improvement Act

I 116TH CONGRESS 1ST SESSION H. R. 3436 To amend title XVIII of the Social Security Act to remove cost-sharing responsibilities for chronic care management services under the Medicare program. IN THE HOUSE OF REPRESENTATIVES JUNE 24, 2019 Ms. DELBENE (for herself and Mr. WELCH) 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 subse- quently 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 remove cost-sharing responsibilities for chronic care management services under the Medicare 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 ‘‘Chronic Care Manage- 4 ment Improvement Act’’. 5 VerDate Sep 11 2014 01:47 Jun 29, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3436.IH H3436 lotter on DSKBCFDHB2PROD with BILLS 2 •HR 3436 IH SEC. 2. REMOVING COST-SHARING RESPONSIBILITIES FOR 1 CHRONIC CARE MANAGEMENT SERVICES 2 UNDER PART B OF THE MEDICARE PROGRAM. 3 (a) IN GENERAL.—Section 1833 of the Social Secu- 4 rity Act (42 U.S.C. 1395l) is amended— 5 (1) in subsection (a)(1), by striking subpara- 6 graph (Z) and inserting the following: ‘‘(Z) with re- 7 spect to chronic care management services (as de- 8 scribed in section 1848(b)(8)) furnished on or after 9 January 1, 2021, the amount paid shall be an 10 amount equal to 100 percent of the lesser of the ac- 11 tual charge for such services or the amount deter- 12 mined under section 1848,’’; and 13 (2) in subsection (b)— 14 (A) in paragraph (9), by striking ‘‘and’’ at 15 the end; and 16 (B) in paragraph (10), by striking the pe- 17 riod at the end and inserting the following: ‘‘, 18 and (11) such deductible shall not apply with 19 respect to chronic care management services (as 20 described in section 1848(b)(8)) furnished on or 21 after January 1, 2021.’’. 22 (b) TECHNICAL AMENDMENTS.— 23 (1) IN GENERAL.—Section 1833(a) of the So- 24 cial Security Act (42 U.S.C. 1395l(a)) is amended— 25 (A) in paragraph (3)— 26 VerDate Sep 11 2014 01:07 Jun 29, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3436.IH H3436 lotter on DSKBCFDHB2PROD with BILLS 3 •HR 3436 IH (i) in subparagraph (A)— 1 (I) by striking ‘‘subparagraph 2 (B)’’ and inserting ‘‘subparagraphs 3 (B), (C), and (D)’’; and 4 (II) by striking ‘‘or’’ at the end; 5 and 6 (ii) by adding at the end the following 7 new subparagraphs: 8 ‘‘(C) with respect to Federally qualified 9 health center services (other than such services 10 that are described in clause (i) or (ii) of sub- 11 paragraph (D)) furnished on or after the imple- 12 mentation date of the prospective payment sys- 13 tem under section 1834(o) for which payment is 14 made under such section, the amounts paid 15 shall be 80 percent of the lesser of the actual 16 charge or the amount determined under such 17 section; and 18 ‘‘(D) with respect to Federally qualified 19 health center services and rural health clinic 20 services that are— 21 ‘‘(i) personalized prevention plan serv- 22 ices (as described in paragraph (1)(X)) or 23 preventive services (as described in para- 24 VerDate Sep 11 2014 01:07 Jun 29, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3436.IH H3436 lotter on DSKBCFDHB2PROD with BILLS 4 •HR 3436 IH graph (1)(Y)) furnished on or after Janu- 1 ary 1, 2011; or 2 ‘‘(ii) chronic care management serv- 3 ices (as described in paragraph (1)(Z)) 4 furnished on or after January 1, 2021; 5 the amounts paid shall be equal to 100 percent 6 of the lesser of the actual charge or the amount 7 determined under subparagraph (A), section 8 1834(o), or section 1848, as applicable);’’; and 9 (B) by striking the matter following para- 10 graph (9). 11 (2) CONFORMING AMENDMENTS.—Section 12 1834(o) of the Social Security Act (42 U.S.C. 13 1395m(o)) is amended— 14 (A) in paragraph (1)(A), by inserting 15 ‘‘(other than such services described in clause 16 (i) or (ii) of section 1833(a)(3)(D))’’ after 17 ‘‘Federally qualified health center services’’; 18 and 19 (B) in paragraph (2)— 20 (i) in subparagraph (A), by inserting 21 ‘‘(other than such services described in 22 clause (i) or (ii) of section 1833(a)(3)(D))’’ 23 after ‘‘services’’; and 24 (ii) in subparagraph (B)(i)— 25 VerDate Sep 11 2014 01:07 Jun 29, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3436.IH H3436 lotter on DSKBCFDHB2PROD with BILLS 5 •HR 3436 IH (I) by inserting ‘‘(other than 1 such services described in clause (i) or 2 (ii) of section 1833(a)(3)(D))’’ after 3 ‘‘Federally qualified health center 4 services’’; and 5 (II) by striking ‘‘section 6 1833(a)(1)(Z)’’ and inserting ‘‘sub- 7 paragraphs (C) and (D) of section 8 1833(a)(3)’’. 9 Æ VerDate Sep 11 2014 01:07 Jun 29, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H3436.IH H3436 lotter on DSKBCFDHB2PROD with BILLS