[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5273 Referred in Senate (RFS)]
<DOC>
114th CONGRESS
2d Session
H. R. 5273
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 8, 2016
Received; read twice and referred to the Committee on Finance
_______________________________________________________________________
AN ACT
To amend title XVIII of the Social Security Act to provide for
regulatory relief under the Medicare program for certain providers of
services and suppliers and increased transparency in hospital coding
and enrollment data, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Helping Hospitals
Improve Patient Care Act of 2016''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--PROVISIONS RELATING TO MEDICARE PART A
Sec. 101. Development of Medicare study for HCPCS version of MS-DRG
codes for similar hospital services.
Sec. 102. Establishing beneficiary equity in the Medicare hospital
readmission program.
Sec. 103. Five-year extension of the rural community hospital
demonstration program.
Sec. 104. Regulatory relief for LTCHs.
Sec. 105. Savings from IPPS MACRA pay-for through not applying
documentation and coding adjustments.
TITLE II--PROVISIONS RELATING TO MEDICARE PART B
Sec. 201. Continuing Medicare payment under HOPD prospective payment
system for services furnished by mid-build
off-campus outpatient departments of
providers.
Sec. 202. Treatment of cancer hospitals in off-campus outpatient
department of a provider policy.
Sec. 203. Treatment of eligible professionals in ambulatory surgical
centers for meaningful use and MIPS.
TITLE III--OTHER MEDICARE PROVISIONS
Sec. 301. Delay in authority to terminate contracts for Medicare
Advantage plans failing to achieve minimum
quality ratings.
Sec. 302. Requirement for enrollment data reporting for Medicare.
Sec. 303. Updating the Welcome to Medicare package.
TITLE I--PROVISIONS RELATING TO MEDICARE PART A
SEC. 101. DEVELOPMENT OF MEDICARE STUDY FOR HCPCS VERSION OF MS-DRG
CODES FOR SIMILAR HOSPITAL SERVICES.
Section 1886 of the Social Security Act (42 U.S.C. 1395ww) is
amended by adding at the end the following new subsection:
``(t) Relating Similar Inpatient and Outpatient Hospital
Services.--
``(1) Development of hcpcs version of ms-drg codes.--
``(A) In general.--Not later than January 1, 2018,
the Secretary shall develop HCPCS versions for MS-DRGs
that is similar to the ICD-10-PCS for such MS-DRGs such
that, to the extent possible, the MS-DRG assignment
shall be similar for a claim coded with the HCPCS
version as an identical claim coded with a ICD-10-PCS
code.
``(B) Coverage of surgical ms-drgs.--In carrying
out subparagraph (A), the Secretary shall develop HCPCS
versions of MS-DRG codes for not fewer than 10 surgical
MS-DRGs.
``(C) Publication and dissemination of the hcpcs
versions of ms-drgs.--
``(i) In general.--The Secretary shall
develop a HCPCS MS-DRG definitions manual and
software that is similar to the definitions
manual and software for ICD-10-PCS codes for
such MS-DRGs. The Secretary shall post the
HCPCS MS-DRG definitions manual and software on
the Internet website of the Centers for
Medicare & Medicaid Services. The HCPCS MS-DRG
definitions manual and software shall be in the
public domain and available for use and
redistribution without charge.
``(ii) Use of previous analysis done by
medpac.--In developing the HCPCS MS-DRG
definitions manual and software under clause
(i), the Secretary shall consult with the
Medicare Payment Advisory Commission and shall
consider the analysis done by such Commission
in translating outpatient surgical claims into
inpatient surgical MS-DRGs in preparing chapter
7 (relating to hospital short-stay policy
issues) of its `Medicare and the Health Care
Delivery System' report submitted to Congress
in June 2015.
``(D) Definition and reference.--In this paragraph:
``(i) HCPCS.--The term `HCPCS' means, with
respect to hospital items and services, the
code under the Healthcare Common Procedure
Coding System (HCPCS) (or a successor code) for
such items and services.
``(ii) ICD-10-PCS.--The term `ICD-10-PCS'
means the International Classification of
Diseases, 10th Revision, Procedure Coding
System, and includes a subsequent revision of
such International Classification of Diseases,
Procedure Coding System.''.
SEC. 102. ESTABLISHING BENEFICIARY EQUITY IN THE MEDICARE HOSPITAL
READMISSION PROGRAM.
(a) Transitional Adjustment for Dual Eligible Population.--Section
1886(q)(3) of the Social Security Act (42 U.S.C. 1395ww(q)(3)) is
amended--
(1) in subparagraph (A), by inserting ``subject to
subparagraph (D),'' after ``purposes of paragraph (1),''; and
(2) by adding at the end the following new subparagraph:
``(D) Transitional adjustment for dual eligibles.--
``(i) In general.--In determining a
hospital's adjustment factor under this
paragraph for purposes of making payments for
discharges occurring during and after fiscal
year 2019, and before the application of clause
(i) of subparagraph (E), the Secretary shall
assign hospitals to groups (as defined by the
Secretary under clause (ii)) and apply the
applicable provisions of this subsection using
a methodology in a manner that allows for
separate comparison of hospitals within each
such group, as determined by the Secretary.
``(ii) Defining groups.--For purposes of
this subparagraph, the Secretary shall define
groups of hospitals based on their overall
proportion, of the inpatients who are entitled
to, or enrolled for, benefits under part A, who
are full-benefit dual eligible individuals (as
defined in section 1935(c)(6)). In defining
groups, the Secretary shall consult the
Medicare Payment Advisory Commission and may
consider the analysis done by such Commission
in preparing the portion of its report
submitted to Congress in June 2013 relating to
readmissions.
``(iii) Minimizing reporting burden on
hospitals.--In carrying out this subparagraph,
the Secretary shall not impose any additional
reporting requirements on hospitals.
``(iv) Budget neutral design methodology.--
The Secretary shall design the methodology to
implement this subparagraph so that the
estimated total amount of reductions in
payments under this subsection equals the
estimated total amount of reductions in
payments that would otherwise occur under this
subsection if this subparagraph did not
apply.''.
(b) Subsequent Adjustments Based on IMPACT Reports.--Section
1886(q)(3) of the Social Security Act (42 U.S.C. 1395ww(q)(3)), as
amended by subsection (a), is further amended by adding at the end the
following new subparagraph:
``(E) Changes in risk adjustment.--
``(i) Consideration of recommendations in
impact reports.--The Secretary may take into
account the studies conducted and the
recommendations made by the Secretary under
section 2(d)(1) of the IMPACT Act of 2014
(Public Law 113-185; 42 U.S.C. 1395lll note)
with respect to the application under this
subsection of risk adjustment methodologies.
Nothing in this clause shall be construed as
precluding consideration of the use of
groupings of hospitals.''.
(c) MedPAC Study on Readmissions Program.--The Medicare Payment
Advisory Commission shall conduct a study to review overall hospital
readmissions described in section 1886(q)(5)(E) of the Social Security
Act (42 U.S.C. 1395ww(q)(5)(E)) and whether such readmissions are
related to any changes in outpatient and emergency services furnished.
The Commission shall submit to Congress a report on such study in its
report to Congress in June 2017.
(d) Addressing Issue of Certain Patients.--Subparagraph (E) of
section 1886(q)(3) of the Social Security Act (42 U.S.C. 1395ww(q)(3)),
as added by subsection (b), is further amended by adding at the end the
following new clause:
``(ii) Consideration of exclusion of
patient cases based on v or other appropriate
codes.--In promulgating regulations to carry
out this subsection with respect to discharges
occurring after fiscal year 2018, the Secretary
may consider the use of V or other ICD-related
codes for removal of a readmission. The
Secretary may consider modifying measures under
this subsection to incorporate V or other ICD-
related codes at the same time as other changes
are being made under this subparagraph.''.
(e) Removal of Certain Readmissions.--Subparagraph (E) of section
1886(q)(3) of the Social Security Act (42 U.S.C. 1395ww(q)(3)), as
added by subsection (b) and amended by subsection (d), is further
amended by adding at the end the following new clause:
``(iii) Removal of certain readmissions.--
In promulgating regulations to carry out this
subsection, with respect to discharges
occurring after fiscal year 2018, the Secretary
may consider removal as a readmission of an
admission that is classified within one or more
of the following: transplants, end-stage renal
disease, burns, trauma, psychosis, or substance
abuse. The Secretary may consider modifying
measures under this subsection to remove
readmissions at the same time as other changes
are being made under this subparagraph.''.
SEC. 103. FIVE-YEAR EXTENSION OF THE RURAL COMMUNITY HOSPITAL
DEMONSTRATION PROGRAM.
(a) Extension.--Section 410A of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (Public Law 108-173; 42
U.S.C. 1395ww note), as amended by sections 3123 and 10313 of the
Patient Protection and Affordable Care Act (Public Law 111-148), is
amended--
(1) in subsection (a)(5), by striking ``5-year extension
period'' and inserting ``10-year extension period''; and
(2) in subsection (g)--
(A) in the subsection heading, by striking ``Five-
Year'' and inserting ``Ten-Year'';
(B) in paragraph (1), by striking ``additional 5-
year'' and inserting ``additional 10-year'';
(C) by striking ``5-year extension period'' and
inserting ``10-year extension period'' each place it
appears;
(D) in paragraph (4)(B)--
(i) in the matter preceding clause (i), by
inserting ``each 5-year period in'' after
``hospital during''; and
(ii) in clause (i), by inserting ``each
applicable 5-year period in'' after ``the first
day of''; and
(E) by adding at the end the following new
paragraphs:
``(5) Other hospitals in demonstration program.--During the
second 5 years of the 10-year extension period, the Secretary
shall apply the provisions of paragraph (4) to rural community
hospitals that are not described in paragraph (4) but are
participating in the demonstration program under this section
as of December 30, 2014, in a similar manner as such provisions
apply to rural community hospitals described in paragraph (4).
``(6) Expansion of demonstration program to rural areas in
any state.--
``(A) In general.--The Secretary shall,
notwithstanding subsection (a)(2) or paragraph (2) of
this subsection, not later than 120 days after the date
of the enactment of this paragraph, issue a
solicitation for applications to select up to the
maximum number of additional rural community hospitals
located in any State to participate in the
demonstration program under this section for the second
5 years of the 10-year extension period without
exceeding the limitation under paragraph (3) of this
subsection.
``(B) Priority.--In determining which rural
community hospitals that submitted an application
pursuant to the solicitation under subparagraph (A) to
select for participation in the demonstration program,
the Secretary--
``(i) shall give priority to rural
community hospitals located in one of the 20
States with the lowest population densities (as
determined by the Secretary using the 2015
Statistical Abstract of the United States); and
``(ii) may consider--
``(I) closures of hospitals located
in rural areas in the State in which
the rural community hospital is located
during the 5-year period immediately
preceding the date of the enactment of
this paragraph; and
``(II) the population density of
the State in which the rural community
hospital is located.''.
(b) Change in Timing for Report.--Subsection (e) of such section
410A is amended--
(1) by striking ``Not later than 6 months after the
completion of the demonstration program under this section''
and inserting ``Not later than August 1, 2018''; and
(2) by striking ``such program'' and inserting ``the
demonstration program under this section''.
SEC. 104. REGULATORY RELIEF FOR LTCHS.
(a) Technical Change to the Medicare Long-Term Care Hospital
Moratorium Exception.--
(1) In general.--Section 114(d)(7) of the Medicare,
Medicaid, and SCHIP Extension Act of 2007 (42 U.S.C. 1395ww
note), as amended by sections 3106(b) and 10312(b) of Public
Law 111-148, section 1206(b)(2) of the Pathway for SGR Reform
Act of 2013 (division B of Public Law 113-67), and section 112
of the Protecting Access to Medicare Act of 2014, is amended by
striking ``The moratorium under paragraph (1)(A)'' and
inserting ``Any moratorium under paragraph (1)''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect as if included in the enactment of section
112 of the Protecting Access to Medicare Act of 2014.
(b) Modification to Medicare Long-Term Care Hospital High Cost
Outlier Payments.--Section 1886(m) of the Social Security Act (42
U.S.C. 1395ww(m)) is amended by adding at the end the following new
paragraph:
``(7) Treatment of high cost outlier payments.--
``(A) Adjustment to the standard federal payment
rate for estimated high cost outlier payments.--Under
the system described in paragraph (1), for fiscal years
beginning on or after October 1, 2017, the Secretary
shall reduce the standard Federal payment rate as if
the estimated aggregate amount of high cost outlier
payments for standard Federal payment rate discharges
for each such fiscal year would be equal to 8 percent
of estimated aggregate payments for standard Federal
payment rate discharges for each such fiscal year.
``(B) Limitation on high cost outlier payment
amounts.--Notwithstanding subparagraph (A), the
Secretary shall set the fixed loss amount for high cost
outlier payments such that the estimated aggregate
amount of high cost outlier payments made for standard
Federal payment rate discharges for fiscal years
beginning on or after October 1, 2017, shall be equal
to 99.6875 percent of 8 percent of estimated aggregate
payments for standard Federal payment rate discharges
for each such fiscal year.
``(C) Waiver of budget neutrality.--Any reduction
in payments resulting from the application of
subparagraph (B) shall not be taken into account in
applying any budget neutrality provision under such
system.
``(D) No effect on site neutral high cost outlier
payment rate.--This paragraph shall not apply with
respect to the computation of the applicable site
neutral payment rate under paragraph (6).''.
SEC. 105. SAVINGS FROM IPPS MACRA PAY-FOR THROUGH NOT APPLYING
DOCUMENTATION AND CODING ADJUSTMENTS.
Section 7(b)(1)(B)(iii) of the TMA, Abstinence Education, and QI
Programs Extension Act of 2007 (Public Law 110-90), as amended by
section 631(b) of the American Taxpayer Relief Act of 2012 (Public Law
122-240) and section 414(1)(B)(iii) of the Medicare Access and CHIP
Reauthorization Act of 2015 (Public Law 114-10), is amended by striking
``an increase of 0.5 percentage points for discharges occurring during
each of fiscal years 2018 through 2023'' and inserting ``an increase of
0.4590 percentage points for discharges occurring during fiscal year
2018 and 0.5 percentage points for discharges occurring during each of
fiscal years 2019 through 2023''.
TITLE II--PROVISIONS RELATING TO MEDICARE PART B
SEC. 201. CONTINUING MEDICARE PAYMENT UNDER HOPD PROSPECTIVE PAYMENT
SYSTEM FOR SERVICES FURNISHED BY MID-BUILD OFF-CAMPUS
OUTPATIENT DEPARTMENTS OF PROVIDERS.
(a) In General.--Section 1833(t)(21) of the Social Security Act (42
U.S.C. 1395l(t)(21)) is amended--
(1) in subparagraph (B)--
(A) in clause (i), by striking ``clause (ii)'' and
inserting ``the subsequent provisions of this
subparagraph''; and
(B) by adding at the end the following new clauses:
``(iii) Deemed treatment for 2017.--For
purposes of applying clause (ii) with respect
to applicable items and services furnished
during 2017, a department of a provider (as so
defined) not described in such clause is deemed
to be billing under this subsection with
respect to covered OPD services furnished prior
to November 2, 2015, if the Secretary received
from the provider prior to December 2, 2015, an
attestation (pursuant to section 413.65(b)(3)
of title 42 of the Code of Federal Regulations)
that such department was a department of a
provider (as so defined).
``(iv) Alternative exception beginning with
2018.--For purposes of paragraph (1)(B)(v) and
this paragraph with respect to applicable items
and services furnished during 2018 or a
subsequent year, the term `off-campus
outpatient department of a provider' also shall
not include a department of a provider (as so
defined) that is not described in clause (ii)
if--
``(I) the Secretary receives from
the provider an attestation (pursuant
to such section 413.65(b)(3)) not later
than December 31, 2016 (or, if later,
60 days after the date of the enactment
of this clause), that such department
met the requirements of a department of
a provider specified in section 413.65
of title 42 of the Code of Federal
Regulations;
``(II) the provider includes such
department as part of the provider on
its enrollment form in accordance with
the enrollment process under section
1866(j); and
``(III) the department met the mid-
build requirement of clause (v) and the
Secretary receives, not later than 60
days after the date of the enactment of
this clause, from the chief executive
officer or chief operating officer of
the provider a written certification
that the department met such
requirement.
``(v) Mid-build requirement described.--The
mid-build requirement of this clause is, with
respect to a department of a provider, that
before November 2, 2015, the provider had a
binding written agreement with an outside
unrelated party for the actual construction of
such department.
``(vii) Audit.--Not later than December 31,
2018, the Secretary shall audit the compliance
with requirements of clause (iv) with respect
to each department of a provider to which such
clause applies. If the Secretary finds as a
result of an audit under this clause that the
applicable requirements were not met with
respect to such department, the department
shall not be excluded from the term `off-campus
outpatient department of a provider' under such
clause.
``(viii) Implementation.--For purposes of
implementing clauses (iii) through (vii):
``(I) Notwithstanding any other
provision of law, the Secretary may
implement such clauses by program
instruction or otherwise.
``(II) Subchapter I of chapter 35
of title 44, United States Code, shall
not apply.
``(III) For purposes of carrying
out this subparagraph with respect to
clauses (iii) and (iv) (and clause
(vii) insofar as it relates to clause
(iv)), $10,000,000 shall be available
from the Federal Supplementary Medical
Insurance Trust Fund under section
1841, to remain available until
December 31, 2018.''; and
(2) in subparagraph (E), by adding at the end the following
new clause:
``(iv) The determination of an audit under
subparagraph (B)(vii).''.
(b) Effective Date.--The amendments made by this section shall be
effective as if included in the enactment of section 603 of the
Bipartisan Budget Act of 2015 (Public Law 114-74).
SEC. 202. TREATMENT OF CANCER HOSPITALS IN OFF-CAMPUS OUTPATIENT
DEPARTMENT OF A PROVIDER POLICY.
(a) In General.--Section 1833(t)(21)(B) of the Social Security Act
(42 U.S.C. 1395l(t)(21)(B)), as amended by section 201(a), is amended--
(1) by inserting after clause (v) the following new clause:
``(vi) Exclusion for certain cancer
hospitals.--For purposes of paragraph (1)(B)(v)
and this paragraph with respect to applicable
items and services furnished during 2017 or a
subsequent year, the term `off-campus
outpatient department of a provider' also shall
not include a department of a provider (as so
defined) that is not described in clause (ii)
if the provider is a hospital described in
section 1886(d)(1)(B)(v) and--
``(I) in the case of a department
that met the requirements of section
413.65 of title 42 of the Code of
Federal Regulations after November 1,
2015, and before the date of the
enactment of this clause, the Secretary
receives from the provider an
attestation that such department met
such requirements not later than 60
days after such date of enactment; or
``(II) in the case of a department
that meets such requirements after such
date of enactment, the Secretary
receives from the provider an
attestation that such department meets
such requirements not later than 60
days after the date such requirements
are first met with respect to such
department.'';
(2) in clause (vii), by inserting after the first sentence
the following: ``Not later than 2 years after the date the
Secretary receives an attestation under clause (vi) relating to
compliance of a department of a provider with requirements
referred to in such clause, the Secretary shall audit the
compliance with such requirements with respect to the
department.''; and
(3) in clause (viii)(III), by adding at the end the
following: ``For purposes of carrying out this subparagraph
with respect to clause (vi) (and clause (vii) insofar as it
relates to such clause), $2,000,000 shall be available from the
Federal Supplementary Medical Insurance Trust Fund under
section 1841, to remain available until expended.''.
(b) Offsetting Savings.--Section 1833(t)(18) of the Social Security
Act (42 U.S.C. 1395l(t)(18)) is amended--
(1) in subparagraph (B), by inserting ``, subject to
subparagraph (C),'' after ``shall''; and
(2) by adding at the end the following new subparagraph:
``(C) Target pcr adjustment.--In applying section
419.43(i) of title 42 of the Code of Federal
Regulations to implement the appropriate adjustment
under this paragraph for services furnished on or after
January 1, 2018, the Secretary shall use a target PCR
that is 1.0 percentage points less than the target PCR
that would otherwise apply. In addition to the
percentage point reduction under the previous sentence,
the Secretary may consider making an additional
percentage point reduction to such target PCR that
takes into account payment rates for applicable items
and services described in paragraph (21)(C) other than
for services furnished by hospitals described in
section 1886(d)(1)(B)(v). In making any budget
neutrality adjustments under this subsection for 2018
or a subsequent year, the Secretary shall not take into
account the reduced expenditures that result from the
application of this subparagraph.''.
(c) Effective Date.--The amendments made by this section shall be
effective as if included in the enactment of section 603 of the
Bipartisan Budget Act of 2015 (Public Law 114-74).
SEC. 203. TREATMENT OF ELIGIBLE PROFESSIONALS IN AMBULATORY SURGICAL
CENTERS FOR MEANINGFUL USE AND MIPS.
(a) In General.--Section 1848(a)(7)(D) of the Social Security Act
(42 U.S.C. 1395w-4(a)(7)(D)) is amended--
(1) by striking ``hospital-based eligible professionals''
and all that follows through ``No payment'' and inserting the
following: ``hospital-based and ambulatory surgical center-
based eligible professionals.--
``(i) Hospital-based.--No payment''; and
(2) by adding at the end the following new clauses:
``(ii) Ambulatory surgical center-based.--
Subject to clause (iv), no payment adjustment
may be made under subparagraph (A) for 2017 and
2018 in the case of an eligible professional
with respect to whom substantially all of the
covered professional services furnished by such
professional are furnished in an ambulatory
surgical center.
``(iii) Determination.--The determination
of whether an eligible professional is an
eligible professional described in clause (ii)
may be made on the basis of--
``(I) the site of service (as
defined by the Secretary); or
``(II) an attestation submitted by
the eligible professional.
Determinations made under subclauses (I) and
(II) shall be made without regard to any
employment or billing arrangement between the
eligible professional and any other supplier or
provider of services.
``(iv) Sunset.--Clause (ii) shall no longer
apply as of the first year that begins more
than 3 years after the date on which the
Secretary determines, through notice and
comment rulemaking, that certified EHR
technology applicable to the ambulatory
surgical center setting is available.''.
(b) Continued Application of Certain Provisions Under MIPS.--
Section 1848(o)(2)(D) of the Social Security Act (42 U.S.C. 1395w-
4(o)(2)(D)) is amended by adding at the end the following new sentence:
``The provisions of subparagraphs (B) and (D) of subsection (a)(7),
including the application of clause (iv) of such subparagraph (D),
shall apply to assessments of MIPS eligible professionals under
subsection (q) with respect to the performance category described in
subsection (q)(2)(A)(iv) in a manner similar to the manner in which
such provisions apply with respect to payment adjustments made under
subsection (a)(7)(A).''.
TITLE III--OTHER MEDICARE PROVISIONS
SEC. 301. DELAY IN AUTHORITY TO TERMINATE CONTRACTS FOR MEDICARE
ADVANTAGE PLANS FAILING TO ACHIEVE MINIMUM QUALITY
RATINGS.
(a) Findings.--Consistent with the studies provided under the
IMPACT Act of 2014 (Public Law 113-185), it is the intent of Congress--
(1) to continue to study and request input on the effects
of socioeconomic status and dual-eligible populations on the
Medicare Advantage STARS rating system before reforming such
system with the input of stakeholders; and
(2) pending the results of such studies and input, to
provide for a temporary delay in authority of the Centers for
Medicare & Medicaid Services (CMS) to terminate Medicare
Advantage plan contracts solely on the basis of performance of
plans under the STARS rating system.
(b) Delay in MA Contract Termination Authority for Plans Failing To
Achieve Minimum Quality Ratings.--Section 1857(h) of the Social
Security Act (42 U.S.C. 1395w-27(h)) is amended by adding at the end
the following new paragraph:
``(3) Delay in contract termination authority for plans
failing to achieve minimum quality rating.--During the period
beginning on the date of the enactment of this paragraph and
through the end of plan year 2018, the Secretary may not
terminate a contract under this section with respect to the
offering of an MA plan by a Medicare Advantage organization
solely because the MA plan has failed to achieve a minimum
quality rating under the 5-star rating system under section
1853(o)(4).''.
SEC. 302. REQUIREMENT FOR ENROLLMENT DATA REPORTING FOR MEDICARE.
Section 1874 of the Social Security Act (42 U.S.C. 1395kk) is
amended by adding at the end the following new subsection:
``(g) Requirement for Enrollment Data Reporting.--
``(1) In general.--Each year (beginning with 2016), the
Secretary shall submit to the Committees on Ways and Means and
Energy and Commerce of the House of Representatives and the
Committee on Finance of the Senate a report on Medicare
enrollment data (and, in the case of part A, on data on
individuals receiving benefits under such part) as of a date in
such year specified by the Secretary. Such data shall be
presented--
``(A) by Congressional district and State; and
``(B) in a manner that provides for such data based
on--
``(i) fee-for-service enrollment (as
defined in paragraph (2));
``(ii) enrollment under part C (including
separate for aggregate enrollment in MA-PD
plans and aggregate enrollment in MA plans that
are not MA-PD plans); and
``(iii) enrollment under part D.
``(2) Fee-for-service enrollment defined.--For purpose of
paragraph (1)(B)(i), the term `fee-for-service enrollment'
means aggregate enrollment (including receipt of benefits other
than through enrollment) under--
``(A) part A only;
``(B) part B only; and
``(C) both part A and part B.''.
SEC. 303. UPDATING THE WELCOME TO MEDICARE PACKAGE.
(a) In General.--Not later than 12 months after the last day of the
period for the request of information described in subsection (b), the
Secretary of Health and Human Services shall, taking into consideration
information collected pursuant to subsection (b), update the
information included in the Welcome to Medicare package to include
information, presented in a clear and simple manner, about options for
receiving benefits under the Medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.), including through the
original medicare fee-for-service program under parts A and B of such
title (42 U.S.C. 1395c et seq., 42 U.S.C. 1395j et seq.), Medicare
Advantage plans under part C of such title (42 U.S.C. 1395w-21 et
seq.), and prescription drug plans under part D of such title (42
U.S.C. 1395w-101 et seq.)). The Secretary shall make subsequent updates
to the information included in the Welcome to Medicare package as
appropriate.
(b) Request for Information.--Not later than 6 months after the
date of the enactment of this Act, the Secretary of Health and Human
Services shall request information, including recommendations, from
stakeholders (including patient advocates, issuers, and employers) on
information included in the Welcome to Medicare package, including
pertinent data and information regarding enrollment and coverage for
Medicare eligible individuals.
Passed the House of Representatives June 7, 2016.
Attest:
KAREN L. HAAS,
Clerk.