Federal - S 870

The CHRONIC Act to address how Medicare handles patients with chronic diseases

Introduced

April 6, 2017

Description

A bill to amend title XVIII of the Social Security Act to implement Medicare payment policies designed to improve management of chronic disease, streamline care coordination, and improve quality outcomes without adding to the deficit.

Our Position

Support

Original Sponsor 1

Co-Sponsors 18

Latest Actions See More/Less

  • Aug. 3, 2017 — Reported to the Senate with an amendment in the nature of a substitute by the Senate Finance Committee and placed on the Senate Legislative Calendar. S Rept 115-146Congressional Record p. S4826

  • May 18, 2017 — Full committee consideration and markup held by the Senate Finance Committee.

    May 18, 2017 — Committee Vote: Medicare Payment Policies for Chronic Conditions and Strokes — Medicare Part D Plans Access
      Carper, D-Del. —

    Amendment that would direct the secretary of Health and Human Services to establish a process, beginning in plan year 2020, for Medicare Part D prescription drug plan sponsors to request claims data from Medicare hospitals and physicians to promote the appropriate use of medications.

    Amendment that would direct the secretary of Health and Human Services to establish a process, beginning in plan year 2020, for Medicare Part D prescription drug plan sponsors to request claims data from Medicare hospitals and physicians to promote the appropriate use of medications.

    Adopted by voice vote.

    May 18, 2017 — Committee Vote: Medicare Payment Policies for Chronic Conditions and Strokes — Vote to Report

    Extend by two years the Independence at Home test program that allows house calls for the frail elderly. Created by the 2010 health law (PL 111-148, PL 111-152), the program is currently set to expire Sept. 30, 2107. The bill also would allow medical practices to remain in this test program for as long as seven years, instead of only five as allowed under current law. Medical practices also would have a window of three years to demonstrate savings, instead of the two-year period now mandated.

    The bill would allow people getting their kidney dialysis at home to have monthly assessment by medical staff via telehealth services.

    The bill also would permanently authorize insurers' use of special-needs plans for the most vulnerable people in Medicare, including those whose disabilities also qualify them for Medicaid. The authority for these plans is set to expire Dec. 31, 2018. The bill would require the Centers for Medicare and Medicaid Services establish procedures by April 1, 2020, to unify grievance processes for special needs plans used for people with disabilities. By Jan. 1, 2020, it would direct CMS to require that insurers incorporate into the special-needs plans medical personnel with demonstrated expertise in applicable fields of medicine and to have an annual evaluation process for how well these plans met goals for patient care.

    The measure also seeks to add more supplemental benefits to insurer-run Medicare Advantage plans by 2020 to aid people coping with chronic conditions. These could include counseling, disease management, acupuncture and fitness benefits. It would require the Government Accountability Office to issue a report on these efforts within five years of the bill's enactment.

    The bill would eliminate a geographic restriction for telehealth services for the case of evaluating strokes, starting in January 2021. This would allow pay for doctors who could handles these diagnoses from a distance. The measure also would task the Department of Health and Human Services with taking steps to expand use of telehealth services covered through insurer-run Medicare Advantage programs, starting in 2020. HHS would need to solicit feedback on this expansion by Nov. 30, 2018.

    The bill would extend until at least 2022 the so-called value-based insurance design program, which is intended to help insurers tailor benefits and cost-sharing policies to serve people with chronic illnesses. It also would allow for a payment of as much as $20 to people enrolled in so-called accountable care organizations for receiving primary care services, a move intended to keep these patients in closer contact with their doctors. This would be available for organizations that have opted to participate in CMS' test program where they may gain or lose money based on how the agency judges their performance in caring for patients, known as a two-sided risk/reward model. The bill also would allow a change in how the ACO model operates, with people being able to choose an organization that then is assigned to coordinate their care. The bill also would ease geographic restrictions on telehealth for ACOs in the two-sided risk model.

    It would require the GAO to report, within 18 months of the bill's enactment, on potential benefits of synchronizing the dispensing drugs for multiple conditions on the same day. It would give the GAO 18 months to report to Congress about use of prescription drugs to control the weight of obese patients. It also would give the GAO 18 months to complete a study on the possible benefits of a new Medicare payment code meant to cover so-called longitudinal comprehensive care services. This would apply when a person receives a diagnosis of a serious or life-threatening illness and would be meant to cover the work of a coordinated group, including social workers and clergy as well as doctors and nurses.

    The bill would apply $270 million from the Medicare Improvement Fund to cover costs of other provisions of the measure. It also would use $5 million from the Medicaid Improvement Fund.

    Extend by two years the Independence at Home test program that allows house calls for the frail elderly. Created by the 2010 health law (PL 111-148, PL 111-152), the program is currently set to expire Sept. 30, 2107. The bill also would allow medical practices to remain in this test program for as long as seven years, instead of only five as allowed under current law. Medical practices also would have a window of three years to demonstrate savings, instead of the two-year period now mandated.

    The bill would allow people getting their kidney dialysis at home to have monthly assessment by medical staff via telehealth services.

    The bill also would permanently authorize insurers' use of special-needs plans for the most vulnerable people in Medicare, including those whose disabilities also qualify them for Medicaid. The authority for these plans is set to expire Dec. 31, 2018. The bill would require the Centers for Medicare and Medicaid Services establish procedures by April 1, 2020, to unify grievance processes for special needs plans used for people with disabilities. By Jan. 1, 2020, it would direct CMS to require that insurers incorporate into the special-needs plans medical personnel with demonstrated expertise in applicable fields of medicine and to have an annual evaluation process for how well these plans met goals for patient care.

    The measure also seeks to add more supplemental benefits to insurer-run Medicare Advantage plans by 2020 to aid people coping with chronic conditions. These could include counseling, disease management, acupuncture and fitness benefits. It would require the Government Accountability Office to issue a report on these efforts within five years of the bill's enactment.

    The bill would eliminate a geographic restriction for telehealth services for the case of evaluating strokes, starting in January 2021. This would allow pay for doctors who could handles these diagnoses from a distance. The measure also would task the Department of Health and Human Services with taking steps to expand use of telehealth services covered through insurer-run Medicare Advantage programs, starting in 2020. HHS would need to solicit feedback on this expansion by Nov. 30, 2018.

    The bill would extend until at least 2022 the so-called value-based insurance design program, which is intended to help insurers tailor benefits and cost-sharing policies to serve people with chronic illnesses. It also would allow for a payment of as much as $20 to people enrolled in so-called accountable care organizations for receiving primary care services, a move intended to keep these patients in closer contact with their doctors. This would be available for organizations that have opted to participate in CMS' test program where they may gain or lose money based on how the agency judges their performance in caring for patients, known as a two-sided risk/reward model. The bill also would allow a change in how the ACO model operates, with people being able to choose an organization that then is assigned to coordinate their care. The bill also would ease geographic restrictions on telehealth for ACOs in the two-sided risk model.

    It would require the GAO to report, within 18 months of the bill's enactment, on potential benefits of synchronizing the dispensing drugs for multiple conditions on the same day. It would give the GAO 18 months to report to Congress about use of prescription drugs to control the weight of obese patients. It also would give the GAO 18 months to complete a study on the possible benefits of a new Medicare payment code meant to cover so-called longitudinal comprehensive care services. This would apply when a person receives a diagnosis of a serious or life-threatening illness and would be meant to cover the work of a coordinated group, including social workers and clergy as well as doctors and nurses.

    The bill would apply $270 million from the Medicare Improvement Fund to cover costs of other provisions of the measure. It also would use $5 million from the Medicaid Improvement Fund.

    Ordered reported favorably to the full Senate 26-0.
  • May 15, 2017 — Additional cosponsor(s): 2

    Nelson, (D-Fla.)Schatz, (D-Hawaii)
  • May 11, 2017 — Additional cosponsor(s): 1

    Wicker, (R-Miss.)
  • April 7, 2017 — Additional cosponsor(s): 2

    Cassidy, (R-La.)Roberts, (R-Kan.)
  • April 6, 2017 — Original cosponsor(s): 13

    Bennet, (D-Colo.)Crapo, (R-Idaho)Thune, (R-S.D.)
    Cardin, (D-Md.)Grassley, (R-Iowa)Warner, (D-Va.)
    Carper, (D-Del.)Isakson, (R-Ga.)Wyden, (D-Ore.)
    Casey, (D-Pa.)McCaskill, (D-Mo.)
    Cornyn, (R-Texas)Stabenow, (D-Mich.)
    (In the legislative day that began on April 4, 2017.)
  • April 6, 2017 — Read twice and referred to: Senate Finance. (In the legislative day that began on April 4, 2017.) Congressional Record p. S2424