WELL Seniors Act of 2020

II 116TH CONGRESS 2D SESSION S. 3237 To amend title XVIII of the Social Security Act to improve the annual wellness visit under the Medicare program. IN THE SENATE OF THE UNITED STATES JANUARY 28, 2020 Mr. KING introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to improve the annual wellness visit 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 ‘‘Wellness and Edu- 4 cation for Longer Lives for Seniors Act of 2020’’ or the 5 ‘‘WELL Seniors Act of 2020’’. 6 SEC. 2. IMPROVEMENTS TO THE MEDICARE ANNUAL 7 WELLNESS VISIT. 8 (a) ADDITIONAL ELEMENTS.— 9 VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3237.IS S3237 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 3237 IS (1) IN GENERAL.—Section 1861(hhh)(2) of the 1 Social Security Act (42 U.S.C. 1395x(hhh)(2)) is 2 amended— 3 (A) in subparagraph (F), by striking ‘‘and 4 nutrition’’ and inserting ‘‘nutrition, mobility, 5 food security, housing security, transportation 6 access, social support, and other social deter- 7 minants of health as determined by the Sec- 8 retary’’; 9 (B) by moving subparagraphs (G) and (H) 10 two ems to the left; 11 (C) by redesignating subparagraph (I) as 12 subparagraph (J); and 13 (D) by inserting after subparagraph (H) 14 the following new subparagraph: 15 ‘‘(I) Screening for balance to identify risk for 16 falls and referral for treatment as appropriate.’’. 17 (2) EFFECTIVE DATE.—The amendments made 18 by paragraph (1) shall apply to items and services 19 furnished on or after January 1, 2021. 20 (b) INCENTIVE PAYMENTS.—Section 1833 of the So- 21 cial Security Act (42 U.S.C. 1395l) is amended by adding 22 at the end the following new subsection: 23 VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3237.IS S3237 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 3237 IS ‘‘(cc) INCENTIVE PAYMENTS FOR ANNUAL 1 WELLNESS VISITS THAT INCLUDE CERTAIN ELE- 2 MENTS.— 3 ‘‘(1) IN GENERAL.—In the case of personalized 4 prevention plan services (as defined in paragraph (1) 5 of section 1861(hhh)) that are furnished on or after 6 January 1, 2021, and that include the element de- 7 scribed in subparagraph (F) of paragraph (2) of 8 such section 1861(hhh) and at least two additional 9 elements described in subparagraphs (A) through 10 (E) and (G) through (J) of such paragraph (2), in 11 addition to the amount of payment that would other- 12 wise be made for such personalized prevention plan 13 services under this part, there also shall be paid an 14 amount equal to 10 percent of the payment amount 15 for the service under this part. 16 ‘‘(2) COORDINATION WITH OTHER PAY- 17 MENTS.—The amount of the additional payment for 18 a service under this subsection and subsection (m) 19 shall be determined without regard to any additional 20 payment for the service under subsection (m) and 21 this subsection, respectively. The amount of the ad- 22 ditional payment for a service under this subsection 23 and subsection (z) shall be determined without re- 24 VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3237.IS S3237 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 3237 IS gard to any additional payment for the service under 1 subsection (z) and this subsection, respectively.’’. 2 (c) EDUCATION AND OUTREACH.—The Secretary of 3 Health and Human Services shall conduct education and 4 outreach activities regarding the coverage of annual 5 wellness visits under the Medicare program, including 6 changes to such visits under the amendments made by 7 subsections (a) and (b). 8 Æ VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S3237.IS S3237 pamtmann on DSKBC07HB2PROD with BILLS