Summary: H.R.4878 — 114th Congress (2015-2016)All Information (Except Text)

There is one summary for H.R.4878. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (03/23/2016)

Better Care, Lower Cost Act

This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to establish an integrated chronic care delivery program through which qualified "Better Care Programs" (BCPs) shall: (1)  promote accountability and better care management for chronically ill patient populations, (2) coordinate items and services under Medicare, and (3) encourage investment in infrastructure and redesigned care processes. A health plan (including a Medicare Advantage plan) or group of providers may participate as a BCP if certified to do so by the Department of Health and Human Services (HHS).

The program shall focus on containing long-term costs and improving the overall health of the Medicare population by implementing, through qualified BCPs, strategies that prevent, delay, or minimize the progression of illness or disability associated with chronic conditions.

With respect to a BCP enrollee who is dually eligible for both Medicare and Medicaid, Medicare shall be the primary payor.

A Medigap policy (supplemental insurance that covers health care costs not covered by Medicare) may not provide for coverage of cost-sharing for Medicare services furnished to a BCP enrollee by a provider that is not a qualified BCP professional.

HHS, acting through the Agency for Healthcare Research and Quality, shall designate and provide core funding for at least three Chronic Care Innovation Centers. To be eligible for such designation and funding, an eligible entity must partner with other specified entities to develop new, evidence-based curricula that addresses the need for chronic care management.