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I
116TH CONGRESS
1ST SESSION H. R. 5212
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
NOVEMBER 21, 2019
Mr. ARRINGTON (for himself, Ms. DELBENE, Mr. MARSHALL, and Mr. BERA)
introduced the following bill; which was referred to the Committee on
Ways and Means, and in addition to the Committee on Energy and Com-
merce, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the jurisdic-
tion 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-
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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 ‘‘Accountable Care in
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Rural America Act’’.
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•HR 5212 IH
SEC. 2. EXCLUSION OF MEDICARE FEE-FOR-SERVICE BENE-
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FICIARIES ASSIGNED TO AN ACO FROM AS-
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PECTS OF OTHER PAYMENT MODELS IN CER-
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TAIN CIRCUMSTANCES INCLUDING DETER-
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MINATION OF REGIONAL ADJUSTMENTS.
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Section 1899(i)(3) of the Social Security Act (42
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U.S.C. 1395jjj(i)(3)) is amended—
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(1) in subparagraph (A), by striking ‘‘subpara-
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graph (B)’’ and inserting ‘‘subparagraphs (B) and
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(C)’’; and
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(2) by adding at the end the following new sub-
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paragraph:
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‘‘(C) EXCLUSION
OF
ASSIGNED
BENE-
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FICIARIES
IN
CERTAIN
CIRCUMSTANCES
IN-
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CLUDING
DETERMINATION
OF
REGIONAL
AD-
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JUSTMENTS.—For performance periods begin-
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ning on or after the date of the enactment of
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this subparagraph, in determining any shared
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savings for any ACO under a model described
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in this paragraph, the Secretary shall—
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‘‘(i) remove Medicare fee-for-service
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beneficiaries who are assigned to that ACO
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from the methodology for calculating re-
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gional expenditures used to establish, up-
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date, and adjust the benchmark expendi-
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tures; and
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•HR 5212 IH
‘‘(ii) otherwise ensure that no such
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ACO is in a less favorable financial posi-
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tion due to differences between the share
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of Medicare fee-for-service beneficiaries as-
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signed to the ACO of all such beneficiaries
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in the counties an ACO operates in com-
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pared to the share of such beneficiaries as-
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signed to other ACOs.’’.
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Æ
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