Summary:
Restoring Access to Medication and Improving Health Savings Act of 2016

This bill amends the Internal Revenue Code to modify the rules that apply to health savings accounts (HSAs) and overpayments of subsidies under the Patient Protection and Affordable Care Act.

Restoring Access to Medication Act of 2016

The bill repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from HSAs, medical savings accounts, and health flexible spending arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs).

Health Care Security Act of 2016

The bill modifies the rules for HSAs with respect to catch-up contributions for married couples, medical expenses incurred before an HSA is established, and contribution limits.

If both spouses of a married couple have family coverage under a high deductible health plan, each spouse may make catch-up contributions to the same HSA. (Catch-up contributions are additional contributions which individuals who are at least 55 years of age may make to an HSA.)

If an HSA is established within 60 days of the beginning of coverage under a high deductible health plan, any distribution from the HSA used to pay a qualified medical expense incurred during that 60-day period after the health coverage began is excludible from gross income. (Under current law, the medical expense must be incurred on or after the date that the HSA is established.)

The bill increases the maximum contribution limits for HSAs to equal the maximum for the sum of the annual deductible and out-of-pocket expenses that may be required to be paid for covered benefits under a high deductible health plan.

Protecting Taxpayers by Recovering Improper Obamacare Subsidy Overpayments Act

The bill eliminates the limitation on the increase in tax imposed upon certain low-income families for advance payments of the tax credit for health insurance premium assistance that exceed the allowable amount of such credit.

restoring access medication improving health savings act bill amends internal_revenue_code modify rules apply health savings accounts hsas overpayments subsidies patient_protection affordable care act restoring access medication act bill repeals provisions internal_revenue_code added patient_protection affordable care act limit payments medications hsas medical savings accounts health flexible spending arrangements prescription drugs insulin allowing distributions accounts counter drugs health care security act bill modifies rules hsas respect catch contributions married couples medical expenses incurred hsa established contribution limits spouses married couple family coverage high deductible health plan spouse catch contributions hsa catch contributions additional contributions individuals years age hsa hsa established days beginning coverage high deductible health plan distribution hsa pay qualified medical expense incurred day period health coverage began excludible gross income current law medical expense incurred date hsa established bill increases maximum contribution limits hsas equal maximum sum annual deductible pocket expenses required paid covered benefits high deductible health plan protecting_taxpayers recovering improper obamacare subsidy overpayments act bill eliminates limitation increase tax imposed certain low income families advance payments tax credit health insurance premium assistance exceed allowable credit


Summary:
Health Insurance Freedom Act of 2015

This bill amends the Patient Protection and Affordable Care Act to allow health insurance that meets state and federal benefit requirements as of October 1, 2013, to be sold on health insurance exchanges. Such insurance fulfills an individual's requirement to maintain minimum essential coverage but is not eligible for premium assistance and is not treated as a bronze, silver, gold, or platinum plan. Currently, health insurance must provide the essential health benefits to be sold on health insurance exchanges and fulfill an individual's requirement to maintain minimum essential coverage.

bill amends patient_protection affordable care act allow health insurance meets state federal benefit requirements october sold health insurance exchanges insurance fulfills individual requirement maintain minimum essential coverage eligible premium assistance treated bronze silver gold platinum plan currently health insurance provide essential health benefits sold health insurance exchanges fulfill individual requirement maintain minimum essential coverage


Summary:
Self-Insurance Protection Act

This bill amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to exclude from the definition of "health insurance coverage" a stop-loss policy obtained by a self-insured health plan or a sponsor of a self-insured group health plan to reimburse the plan or sponsor for losses incurred in providing health benefits to plan participants in excess of a level set forth in the stop-loss policy.

bill amends public_health_service_act employee retirement income security act erisa internal revenue code exclude definition health insurance coverage stop loss policy obtained self insured health plan sponsor self insured group health plan reimburse plan sponsor losses incurred providing health benefits plan participants excess level set forth stop loss policy


Summary:
This bill amends the National Defense Authorization Act for Fiscal Year 2013 to permit an affected eligible beneficiary who was enrolled in TRICARE Prime as of September 30, 2013, and as of December 25, 2013, resided farther than 100 miles from a military medical treatment facility, to make the one-time election to continue TRICARE Prime coverage.

Makes this Act effective as if included in the enactment of the National Defense Authorization Act for Fiscal Year 2014.

bill amends national_defense_authorization_act fiscal year permit affected eligible beneficiary enrolled tricare prime september december resided miles military medical treatment facility time election continue tricare prime coverage makes act effective included enactment national_defense_authorization_act fiscal year


Summary:
Medicare Patient Empowerment Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to allow any Medicare beneficiary to enter into a contract with an eligible professional (regardless of whether a participating or non-participating physician or practitioner) for any item or service covered by Medicare. Allows such beneficiaries to submit a claim for Medicare payment in the amount that would otherwise apply, except that where the professional is considered to be non-participating, payment shall be paid as if the professional were participating.

Defines eligible professional as a physician, a physician assistant, nurse practitioner, clinical nurse specialist, a certified registered nurse anesthetist, a certified nurse-midwife, a clinical social worker, a clinical psychologist, a clinical psychologist, a physical or or occupational therapist or a qualified speech-language pathologist, or a qualified audiologist.

Requires a Medicare beneficiary to agree in writing in such a contract to: (1) pay the eligible professional for a Medicare-covered item or service; and (2) submit (in lieu of the eligible professional) a claim for Medicare payment. Allows a beneficiary, however, to negotiate, as a term of the contract, for the eligible professional to file such claims on the beneficiary's behalf.

Preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.

medicare patient empowerment act amends title xviii medicare social security act allow medicare beneficiary enter contract eligible professional regardless participating non participating physician practitioner item service covered medicare allows beneficiaries submit claim medicare payment apply professional considered non participating payment shall paid professional participating defines eligible professional physician physician assistant nurse practitioner clinical nurse specialist certified registered nurse anesthetist certified nurse midwife clinical social worker clinical psychologist clinical psychologist physical occupational therapist qualified speech language qualified audiologist requires medicare beneficiary agree writing contract pay eligible professional medicare covered item service submit lieu eligible professional claim medicare payment allows beneficiary negotiate term contract eligible professional file claims beneficiary behalf preempts state laws limiting charges physician practitioner services medicare payment


Summary:
Medicare Hearing Aid Coverage Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to repeal the exclusion, and allow coverage, of hearing aids and examinations for them.

The Government Accountability Office is directed to study programs that provide assistance for hearing aids and related examinations for individuals with hearing loss.

bill amends title xviii medicare social security act repeal exclusion allow coverage hearing aids examinations government_accountability_office directed study programs provide assistance hearing aids related examinations individuals hearing loss


Summary:
Health Insurance Freedom Act of 2015

Permits a health insurance issuer that had in effect health insurance coverage in the group or individual market on any date during 2013 to continue offering that coverage outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats that coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage.

Applies only to coverage in states where the state insurance commissioner elects to apply these provisions.

permits health insurance issuer effect health insurance coverage group individual market date continue offering coverage outside health care exchange established patient_protection affordable care act treats coverage grandfathered health plan purposes individual meeting requirement maintain minimum essential health coverage applies coverage states state insurance commissioner elects apply provisions


Summary:
Preventing Diabetes in Medicare Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to extend Medicare coverage to medical nutrition therapy services for people with pre-diabetes and risk factors for developing type-2 diabetes.

preventing diabetes medicare_act amends title xviii medicare social security act extend medicare coverage medical nutrition therapy services people pre diabetes risk factors developing type-2 diabetes


Summary: Amends the Internal Revenue Code to treat membership in a tax-exempt health care sharing ministry as coverage under a high deductible health plan for purposes of the tax deduction for contributions to a health savings account.

amends internal revenue code treat membership tax exempt health care sharing ministry coverage high deductible health plan purposes tax deduction contributions health savings account


Summary:
This bill amends the Patient Protection and Affordable Care Act to eliminate the funding mechanism for the transitional reinsurance program. Currently, issuers of individual, group, and self-funded plans are required to pay a fee in 2014, 2015, and 2016 to fund the three-year transitional reinsurance program. Under the transitional reinsurance program, non-grandfathered individual market plans that enroll high-cost individuals are eligible for reinsurance payments. This bill eliminates the requirement for issuers to pay a fee in 2015 and 2016. Instead, it authorizes appropriations for the program.

This bill also requires the Government Accountability Office to audit 2014 expenditures under the transitional reinsurance program.

bill amends patient_protection affordable care act eliminate funding mechanism transitional reinsurance program currently issuers individual group self funded plans required pay fee fund year transitional reinsurance program transitional reinsurance program non grandfathered individual market plans enroll high cost individuals eligible reinsurance payments bill eliminates requirement issuers pay fee instead authorizes appropriations program bill requires government_accountability_office audit expenditures transitional reinsurance program


Summary: Directs the Secretary of Veterans Affairs (VA) to use the Secretary's existing authority to furnish health care to veterans at non-VA facilities to provide health care at non-VA facilities to veterans who reside more than 40 miles driving distance from the closest VA medical facility providing the care they seek.

directs secretary veterans_affairs use secretary existing authority furnish health care veterans non-va facilities provide health care non-va facilities veterans reside miles driving distance closest medical facility providing care seek


Summary:
No Exemption for Washington from Obamacare Act

This bill amends the Patient Protection and Affordable Care Act to extend the requirement for participation in a health insurance exchange to the President, Vice President, executive branch political appointees, and employees of congressional committees and leadership offices of Congress. Currently, this requirement applies to Members of Congress and their staff.

The government is prohibited from contributing to or subsidizing the health insurance coverage of officials and employees subject to this requirement.

exemption washington obamacare act bill amends patient_protection affordable care act extend requirement participation health insurance exchange president vice president executive branch political appointees employees congressional committees leadership offices congress currently requirement applies members congress staff government prohibited contributing subsidizing health insurance coverage officials employees subject requirement


Summary:
Middle Class Health Benefits Tax Repeal Act of 2015

Amends the Internal Revenue Code to repeal, beginning with taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans).

middle class health benefits tax repeal act amends internal revenue code repeal beginning taxable years beginning december excise tax employer sponsored health care coverage excess benefit high cost plans


Summary:
Improving the Quality of Disability Decisions Act of 2015

This bill amends titles II (Old Age, Survivors, and Disability Insurance) (OASDI) and XVI (Supplemental Security Income) (SSI) of the Social Security Act to direct the Social Security Administration (SSA) to conduct pre-effectuation and post-effectuation quality reviews of hearing dispositions with respect to decisions in connection with applications for OASDI or SSI benefits, in a sufficient number to ensure compliance with laws, regulations, and other guidance.

The SSA shall report annually Congress on: (1) the total number of cases selected for quality review, (2) the number in which a decision is remanded, and (3) the number in which a decision is modified or reversed.

improving quality disability decisions act bill amends titles old age survivors disability_insurance oasdi xvi supplemental security income ssi social security act direct social_security_administration ssa conduct pre post quality reviews hearing dispositions respect decisions connection applications oasdi ssi benefits sufficient number ensure compliance laws regulations guidance ssa shall report annually congress total number cases selected quality review number decision remanded number decision modified


Summary:
Flexible Spending Account Act or the FSA Act

This bill amends the Internal Revenue Code to repeal after 2015 the $2,500 limitation on salary reduction contributions to a health flexible spending arrangement under a cafeteria plan.

flexible spending account act fsa act bill amends internal_revenue_code repeal limitation salary reduction contributions health flexible spending arrangement cafeteria plan


Summary: Directs the Department of Defense to provide transportation on scheduled and unscheduled military flights within the United States and on scheduled overseas flights on a space-available basis for veterans with a service-connected, permanent disability rated as total on the same basis as such transportation is provided to members of the Armed Forces entitled to retired or retainer pay.

directs department_of_defense provide transportation scheduled unscheduled military flights united_states scheduled overseas flights space available basis veterans service connected permanent disability rated total basis transportation provided members armed_forces entitled retired retainer pay


Summary:
Rural Veterans Travel Enhancement Act of 2015

Makes permanent the authority of the Department of Veterans Affairs (VA) to transport individuals to and from VA facilities in connection with vocational rehabilitation, counseling, examination, treatment, or care.

Treats Vet Centers (centers for readjustment counseling and related mental health services for veterans) as VA facilities for purposes of providing payment of actual expenses of travel or allowance for travel to or from a VA facility.

Amends the Caregivers and Veterans Omnibus Health Services Act of 2010 to reauthorize through FY2020 a grant program to provide innovative transportation options to veterans in highly rural areas.

enhancement act makes permanent authority department_of_veterans_affairs transport individuals facilities connection vocational rehabilitation counseling examination treatment care centers readjustment counseling related mental health services veterans facilities purposes providing payment actual expenses travel allowance travel facility amends caregivers veterans_omnibus_health_services act reauthorize fy2020 grant program provide innovative transportation options veterans highly rural areas


Summary:
Empowering Patients First Act of 2015

This bill repeals the Patient Protection and Affordable Care Act and the health care provisions of the Health Care and Education and Reconciliation Act of 2010, effective as of their enactment. This bill replaces those provisions with amendments to the Internal Revenue Code, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 (ERISA) to address health care coverage.

The bill provides for refundable tax credits for health insurance coverage and health savings account (HSA) contributions.

The bill raises the annual HSA contribution limit, expands eligibility for tax-deductible HSA contributions, and allows HSAs to be used to pay periodic or capitated primary care fees.

A limit is placed on the amount of an employer's contribution to health coverage that can be excluded from the employee's taxable income.

The Department of Health and Human Services (HHS) must provide a grant to each state for high-risk pools or reinsurance pools to subsidize health insurance for high-risk populations and individuals.

Funds authorized, tax credits, and tax deductions under this Act may not be used to pay for an abortion or health coverage that includes abortion, with exceptions.

This bill provides for the establishment and governance of independent health pools, entities that form risk pools to offer health insurance coverage to their members.

Small Business Health Fairness Act of 2015

This bill provides for the establishment and governance of association health plans, which are group health plans sponsored by business associations that meet certain ERISA certification requirements.

Health insurers offering individual coverage may deny coverage to an individual, outside of open enrollment periods. Preexisting conditions may be excluded from coverage under certain conditions.

Individual health insurance coverage is governed by the laws of a state designated by the health insurance issuer.

HHS must issue clinical practice guidelines. The bill specifies how these guidelines may be used in a health care lawsuit.

HHS may not use comparative effectiveness research or patient-centered outcomes research to deny coverage of an item or service under a federal health care program. This bill amends title XVIII (Medicare) of the Social Security Act to permit Medicare beneficiaries to contract with a physician or practitioner for covered health care and submit a claim for payment under Medicare. Health care professionals are exempted from federal and state antitrust laws in connection with negotiations with a health plan to provide health care items or services.

empowering patients act bill repeals patient_protection affordable care act health care provisions health_care_and_education reconciliation act effective enactment bill replaces provisions amendments internal_revenue_code public_health_service_act employee retirement income security act erisa address health care coverage bill provides refundable tax credits health insurance coverage health savings account hsa contributions bill raises annual hsa contribution limit expands eligibility tax deductible hsa contributions allows hsas pay periodic capitated primary care fees limit placed employer contribution health coverage excluded employee taxable income department_of_health_and_human_services hhs provide grant state high risk pools reinsurance pools subsidize health insurance high risk populations individuals funds authorized tax credits tax deductions act pay abortion health coverage includes abortion exceptions bill provides establishment governance independent health pools entities form risk pools offer health insurance coverage members small business health fairness act bill provides establishment governance association health plans group health plans sponsored business associations meet certain erisa certification requirements health insurers offering individual coverage deny coverage individual outside open enrollment periods preexisting conditions excluded coverage certain conditions individual health insurance coverage governed laws state designated health insurance issuer hhs issue clinical practice guidelines bill specifies guidelines health care lawsuit hhs use comparative effectiveness research patient centered outcomes research deny coverage item service federal health care program bill amends title xviii medicare social security act permit medicare beneficiaries contract physician practitioner covered health care submit claim payment medicare health care professionals exempted federal state antitrust laws connection negotiations health plan provide health care items services


Summary:
Seniors' Health Care Choice Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act (SSA) to establish: (1) a special enrollment period under Medicare part B (Supplementary Medical Insurance) for an individual enrolled in COBRA (health insurance continuation benefits) continuation coverage who elected not to enroll under part B during the individual's initial enrollment period, and (2) a three-month open enrollment period starting with 2015 and recurring in the first three months of each subsequent year in which a Medicare Advantage (MA)-eligible individual under Medicare part C (Medicare+Choice) may change his or her Medicare enrollment election.

seniors health care choice act amends title xviii medicare social security act ssa establish special enrollment period medicare supplementary_medical_insurance individual enrolled cobra health insurance continuation benefits continuation coverage elected enroll individual initial enrollment period month open enrollment period starting recurring months subsequent year medicare_advantage individual medicare change medicare enrollment election


Summary:
Medicare Beneficiary Preservation of Choice Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited.

medicare_beneficiary_preservation_of_choice_act bill amends title xviii medicare social security act expand modify enrollment disenrollment options medicare_advantage eligible individuals specifically bill extends annual period individual enrolled elect instead receive benefits original medicare fee service ffs program elect change qualified prescription drug coverage furthermore eligible individual enrolled period change previous election respect receiving benefits including changing plan unsolicited marketing period prohibited


Summary:
Medicare Advantage Coverage Transparency Act of 2015

Amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services (HHS) (in effect, the Centers for Medicare and Medicaid Services) to report to specified congressional committees by May 1 of each year on enrollment data for all Medicare programs (including on individuals receiving benefits under Medicare part A [Hospital Insurance]) for the plan year or, in the case of enrollment under both part A and part B (Supplementary Medical Insurance), for the fiscal year or year (as applicable), ending before January 1.

The report must also cover enrollment under a MedicareAdvantage plan under part C (Medicare+Choice Program) and enrollment under part D (Voluntary Prescription Drug Benefit Program).

If HHS is unable to submit such a report by May 1 of any year it shall notify those committees of the inability by April 30, with an explanation and the date by which the report will be made, which shall be not later than June 1.

amends title xviii medicare social security act direct department_of_health_and_human_services hhs effect centers medicare medicaid_services report specified congressional committees year enrollment data medicare programs including individuals receiving benefits medicare hospital insurance plan year case enrollment fiscal year year applicable ending january report cover enrollment medicareadvantage plan program enrollment voluntary prescription drug benefit program hhs unable submit report year shall notify committees inability april explanation date report shall later june


Summary:
Seniors' Health Care Plan Protection Act of 2015

(Sec. 2) States the intent of Congress to: (1) continue to study and request input on the effects of socioeconomic status and dual-eligible populations on the Medicare Advantage (MA) STARS rating system before reforming it, and, pending study and input results; (2) delay Centers for Medicare and Medicaid Services authority to terminate MA plan contracts solely on the basis of performance under the STARS rating system.

Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to prohibit the Department of Health and Human Services, through the end of plan year 2018, from terminating a contract with respect to the offering of an MA plan by a MA organization solely because the plan has failed to achieve a minimum quality rating under the 5-star rating system.

seniors health care plan protection act sec states intent congress continue study request input effects socioeconomic status dual eligible populations stars rating system reforming pending study input results delay centers medicare medicaid_services authority terminate plan contracts solely basis performance stars rating system amends title xviii medicare social security act prohibit department_of_health_and_human_services end plan year terminating contract respect offering plan organization solely plan failed achieve minimum quality rating star rating system


Summary:
Increasing Regulatory Fairness Act of 2015

(Sec. 2) This bill amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services, by regulation and in accordance with certain notice and public comment requirements, to determine and announce annually for 2017 and each subsequent year:

 the annual MedicareAdvantage (MA) capitation rate for each MA payment area for the year concerned, the risk and other factors to be used in adjusting such rates for monthly payments in such year, the MA region-specific non-drug monthly benchmark amount for each MA region and each MA regional plan for which a bid was submitted, and the major policy changes to the risk adjustment model and the 5-star rating system that are determined to have an economic impact.

increasing regulatory fairness act sec bill amends title xviii medicare social security act direct department_of_health_and_human_services regulation accordance certain notice public comment requirements determine announce annually subsequent year annual medicareadvantage capitation rate payment area year concerned risk factors adjusting rates monthly payments year region specific non drug monthly benchmark region regional plan bid submitted major policy changes risk adjustment model star rating system determined economic impact


Summary:
Helping Veterans Save for Health Care Act of 2015

Amends the Internal Revenue Code to provide that a veteran receiving hospital care or medical services for a service-connected disabililty is not disqualified from participating in or contributing to a tax-preferred health savings account.

amends internal revenue code provide veteran receiving hospital care medical services service connected disqualified participating contributing tax preferred health savings account


Summary:
Preservation of Access for Seniors in Medicare Advantage Act of 2015

(Sec. 2) This bill requires the Department of Health and Human Services (HHS) to establish a three-year demonstration program (extendable if necessary to four or five years) to test the use of value-based insurance design methodologies under the eligible Medicare Advantage (MA) plans offered by MA organizations under part C (Medicare+Choice Program) of title XVIII (Medicare) of the Social Security Act (SSAct).

"Value-based insurance design methodology" is one for identifying specific prescription medications, and clinical services payable under Medicare, for which copayments, coinsurance, or both would improve the management of specific chronic clinical conditions because of the high value and effectiveness of such medications and services for such specific chronic clinical conditions, as approved by HHS.

HHS may expand the duration and scope of the demonstration program to an appropriate extent if specified requirements are met.

(Sec. 3) The annual 45-day period for disenrollment from MA plans to elect to receive benefits under the original Medicare fee-for-service program, and to elect coverage under part D (Voluntary Prescription Drug Benefit Program), shall end on December 31, 2015.

Starting in 2016, a Medicare Advantage eligible individual, during the first three months of any year, may change a previous election to elect to receive benefits through the original Medicare fee-for-service program or an MA plan, and to elect coverage under part D.

This continuous open enrollment and disenrollment period during the first three months of any year starting in 2016 shall apply with respect to a prescription drug plan only in the case of an individual who, previous to such change in enrollment, is enrolled in a MA plan.

No unsolicited marketing or marketing materials may be sent to such an eligible individual during the continuous open enrollment and disenrollment period.

(Sec. 4) This bill also amends part B (Supplementary Medical Insurance) of SSAct title XVIII to revise requirements (in effect, changing payment methodologies from 95% of the Average Wholesale Price to the Average Sales Price plus six) for payments for infusion drugs and biologicals furnished through durable medical equipment on or after January 1, 2017.

(Sec. 5) It is the sense of Congress that HHS:

 has incorrectly interpreted the determination of blended benchmark amounts as prohibiting any Medicare quality incentive payments with respect to MA plans that exceed the payment benchmark cap for the area served by those plans; and should immediately apply quality incentive payments with respect to such MA plans without regard to specified limits.

medicare advantage act sec bill requires department_of_health_and_human_services hhs establish year demonstration program necessary years test use value based insurance design methodologies eligible medicare_advantage plans offered organizations program title xviii medicare social security act ssact value based insurance design methodology identifying specific prescription medications clinical services payable medicare copayments coinsurance improve management specific chronic clinical conditions high value effectiveness medications services specific chronic clinical conditions approved hhs hhs expand duration scope demonstration program appropriate extent specified requirements met sec annual day period disenrollment plans elect receive benefits original medicare fee service program elect coverage voluntary prescription drug benefit program shall end december starting medicare_advantage eligible individual months year change previous election elect receive benefits original medicare fee service program plan elect coverage continuous open enrollment disenrollment period months year starting shall apply respect prescription drug plan case individual previous change enrollment enrolled plan unsolicited marketing marketing materials sent eligible individual continuous open enrollment disenrollment period sec bill amends ssact title xviii revise requirements effect changing payment methodologies plus payments infusion drugs biologicals furnished durable medical equipment january sec sense congress hhs incorrectly interpreted determination blended benchmark amounts prohibiting medicare quality incentive payments respect plans exceed payment benchmark cap area served plans immediately apply quality incentive payments respect plans regard specified limits


Summary:
Senior's Health Care Plan Protection Act of 2015

(Sec. 2) It is the intent of Congress to: (1) continue to study and request input on the effects of socioeconomic status and dual-eligible populations on the five-star quality rating system for Medicare Advantage (MA) plans before reforming it, and, pending study and input results, (2) delay Centers for Medicare & Medicaid (CMS) authority to terminate MA plan contracts solely on the basis of performance under the five-star rating system.

The Department of Health and Human Services (HHS) may not, through the end of plan year 2018, terminate a contract with respect to the offering of an MA plan by an MA organization solely because the plan has failed to achieve a minimum quality rating under the five-star rating system.

(Sec. 3) This bill amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSAct) to direct HHS (in effect, CMS) to revise for 2017, and periodically afterwards, the system for risk adjustments to payments to Medicare+Choice organizations so that an individual's risk score takes into account the number of chronic conditions with which the individual has been diagnosed.

HHS must, including an actuarial opinion of the CMS Chief Actuary, evaluate the impacts of:

 including two years of data to compare the models used to determine the risk scores for 2013 and 2014, removing the diagnosis codes related to chronic kidney disease in the 2014 risk adjustment model, and including 10% of encounter data in computing payment for 2016 and CMS readiness to incorporate encounter data in risk scores. HHS shall also analyze the best practices of MA plans to slow disease progression related to chronic kidney disease.

HHS shall then, if appropriate, make revisions to the risk adjustment system, based on such an evaluation or analysis, to better reflect and appropriately weight for the population served.

(Sec. 4) Congress declares that:

 the five-star quality rating system for MA plans lacks proper accounting for the socioeconomic status of plan enrollees and the extent to which those plans serve individuals also eligible for medical assistance under SSAct title XIX (Medicaid); and Congress will work with CMS and stakeholders, including beneficiary groups and managed care organizations, to ensure that the five-star quality rating system for MA plans properly accounts for the socioeconomic status of plan enrollees and the extent to which plans serve them. (Sec. 5) It is also the sense of Congress that HHS should:

 periodically monitor and improve the risk adjustment model for payments to MA organizations to ensure that it accurately accounts for beneficiary risk; closely examine and adjust as necessary the current MA risk adjustment methodology to ensure that plans enrolling beneficiaries with the greatest health care needs receive adequate reimbursement to deliver high-quality care and other services to help beneficiaries avoid costly complications and further progression of chronic conditions; and reconsider the implementation of changes in the MA risk adjustment methodology finalized for 2016 and, to the extent appropriate, use the risk methodology finalized in 2015 for one additional year.

senior health care plan protection act sec intent congress continue study request input effects socioeconomic status dual eligible populations star quality rating system medicare_advantage plans reforming pending study input results delay centers cms authority terminate plan contracts solely basis performance star rating system department_of_health_and_human_services hhs end plan year terminate contract respect offering plan organization solely plan failed achieve minimum quality rating star rating system sec bill amends title xviii medicare social security act ssact direct hhs effect cms revise periodically system risk adjustments payments organizations individual risk score takes account number chronic conditions individual diagnosed hhs including actuarial opinion cms chief actuary evaluate impacts including years data compare models determine risk scores removing diagnosis codes related chronic kidney disease risk adjustment model including encounter data computing payment cms readiness incorporate encounter data risk scores hhs shall analyze best practices plans slow disease progression related chronic kidney disease hhs shall appropriate revisions risk adjustment system based evaluation analysis better reflect appropriately weight population served sec congress declares star quality rating system plans lacks proper accounting socioeconomic status plan enrollees extent plans serve individuals eligible medical assistance ssact title xix medicaid congress work cms stakeholders including beneficiary groups managed care organizations ensure star quality rating system plans properly accounts socioeconomic status plan enrollees extent plans serve sec sense congress hhs periodically monitor improve risk adjustment model payments organizations ensure accurately accounts beneficiary risk closely examine adjust necessary current risk adjustment methodology ensure plans enrolling beneficiaries greatest health care needs receive adequate reimbursement deliver high quality care services help beneficiaries avoid costly complications progression chronic conditions reconsider implementation changes risk adjustment methodology finalized extent appropriate use risk methodology finalized additional year


Summary:
Restoring Equity, Saving Coverage, and Undoing Errors Act of 2015 or the RESCUE America's Health Care Act of 2015

This bill applies only: (1) if the Supreme Court determines that the premium tax credit under the Patient Protection and Affordable Care Act (PPACA) is not applicable to health plans purchased through the federal health insurance exchange, and (2) in states without a state health insurance exchange.

This bill amends the Internal Revenue Code to allow a tax credit for individuals with health insurance who are ineligible for federal health care and not enrolled in an employer-subsidized group health plan.

The Department of the Treasury must make payments to health insurers on behalf of taxpayers eligible for the tax credit.

This bill repeals certain provisions of PPACA and the Health Care and Education Reconciliation Act of 2010 relating to health insurance, health savings accounts, and health flexible spending accounts. Provisions amended by the repealed provisions are restored.

Any health plan fulfills an individual's requirement to maintain minimum essential coverage.

Dental plans no longer need to provide pediatric dental benefits to be offered on a health insurance exchange.

This bill amends the Public Health Service Act to define individual health pools (IHPs) as nonprofit entities that form health insurance risk pools. IHPs are prohibited from conditioning membership on an individual's health status and must offer the same coverage to all members. State benefit requirements and restrictions on premium variation do not apply to IHPs.

Health insurers in the individual market must offer coverage to all individuals.

A health insurer may exclude coverage for a preexisting condition or vary premiums based on health status only for individuals who have not had continuous coverage for the last 18 months.

saving coverage health care act bill applies supreme_court determines premium tax credit patient_protection affordable care act ppaca applicable health plans purchased federal health insurance exchange states state health insurance exchange bill amends internal_revenue_code allow tax credit individuals health insurance ineligible federal health care enrolled employer subsidized group health plan department_of_the_treasury payments health insurers behalf taxpayers eligible tax credit bill repeals certain provisions ppaca health_care_and_education reconciliation act relating health insurance health savings accounts health flexible spending accounts provisions amended repealed provisions restored health plan fulfills individual requirement maintain minimum essential coverage dental plans longer need provide pediatric dental benefits offered health insurance exchange bill amends public_health_service_act define individual health pools nonprofit entities form health insurance risk pools prohibited conditioning membership individual health status offer coverage members state benefit requirements restrictions premium variation apply health insurers individual market offer coverage individuals health insurer exclude coverage preexisting condition vary premiums based health status individuals continuous coverage months


Summary:
Insurance Rate Transparency Act

This bill amends the Public Health Service Act to require the Department of Health and Human Services to report to Congress within 30 days of receiving information on health insurance premium increases for the 2016 plan year on the increase with information presented according to specified categories of consumers (e.g., single, non-smoking male who is 30 years of age).

insurance rate transparency act bill amends public_health_service_act require department_of_health_and_human_services report congress days receiving information health insurance premium increases plan year increase information presented according specified categories consumers single non smoking male years age


Summary:
Commonsense Reporting and Verification Act of 2015

This bill requires the Department of Treasury to implement and maintain a voluntary prospective reporting system for employers subject to the employer mandate under the Patient Protection and Affordable Care Act (PPACA).

Employers satisfy the information return requirement if they voluntarily report general information about the health coverage offered to full-time employees. Employers satisfy the employee statement requirement if they provide statements to employees after receiving exchange notification that employee or spouse or dependent enrolled in a qualified health plan or qualified for premium tax credits or cost-sharing subsidies.

The legislation amends the Internal Revenue Code to: (1) permit employers and health insurance issuers that provide minimum essential coverage to submit an information return with names and birth dates of covered dependents if the employer or health insurance issuer does not already collect or maintain their taxpayer identification numbers, and (2) permit electronic delivery of employee statement if employee consented previously to electronic delivery of other notices and does not refuse consent in writing.

It directs the Government Accountability Office to: (1) evaluate the exchange notification and appeals processes for employers whose employee or spouse or dependent enrolls in a qualified health plan or qualifies for premium tax credits or cost-sharing subsidies, and (2) evaluate the prospective reporting system functionality.

The legislation permits a health insurance exchange to automatically reenroll an individual into a qualified health plan after annually redetermining the individual's eligibility for premium tax credits or cost-sharing subsidies.

verification act bill requires department_of_treasury implement maintain voluntary prospective reporting system employers subject employer mandate patient_protection affordable care act ppaca employers satisfy information return requirement voluntarily report general information health coverage offered time employees employers satisfy employee statement requirement provide statements employees receiving exchange notification employee spouse dependent enrolled qualified health plan qualified premium tax credits cost sharing subsidies legislation amends internal_revenue_code permit employers health insurance issuers provide minimum essential coverage submit information return names birth dates covered dependents employer health insurance issuer collect maintain taxpayer identification numbers permit electronic delivery employee statement employee consented previously electronic delivery notices refuse consent writing directs government_accountability_office evaluate exchange notification appeals processes employers employee spouse dependent enrolls qualified health plan qualifies premium tax credits cost sharing subsidies evaluate prospective reporting system functionality legislation permits health insurance exchange automatically reenroll individual qualified health plan annually redetermining individual eligibility premium tax credits cost sharing subsidies


Summary:
Cancer Drug Coverage Parity Act of 2015

This bill amends the Public Health Service Act to require a group or individual health plan that covers anticancer medications administered by a health care provider to provide no less favorable coverage for anticancer medications administered by a patient. A plan may apply to patient-administered anticancer medications only the cost-sharing and limitations that apply to anticancer medications administered by a health care provider.

These requirements apply to medication approved by the Food and Drug Administration that is prescribed based on a finding by the treating physician that the medication is medically necessary for cancer treatment and is clinically appropriate in terms of type, frequency, extent site, and duration.

To comply with these requirements, health plans may not, for anticancer medications: (1) change or replace benefits to increase out-of-pocket costs; (2) reclassify benefits to increase costs; or (3) apply more restrictive limitations to orally administered medications than to intravenously administered or injected medications.

bill amends public_health_service_act require group individual health plan covers anticancer medications administered health care provider provide favorable coverage anticancer medications administered patient plan apply patient administered anticancer medications cost sharing limitations apply anticancer medications administered health care provider requirements apply medication approved food_and_drug_administration prescribed based finding treating physician medication medically necessary cancer treatment clinically appropriate terms type frequency extent site duration comply requirements health plans anticancer medications change replace benefits increase pocket costs reclassify benefits increase costs apply restrictive limitations orally administered medications intravenously administered injected medications


Summary:
Help Extend Auditory Relief (HEAR) Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to cover aural rehabilitation services, hearing aids as durable medical equipment, audiology rehabilitation services, and related hearing services.

help extend auditory relief hear act amends title xviii medicare social security act cover rehabilitation services hearing aids durable medical equipment audiology rehabilitation services related hearing services


Summary:
Patient Freedom Act of 2015

This bill provides states with three options regarding title I (provisions on health insurance reform, exchanges, and subsidies) of the Patient Protection and Affordable Care Act (PPACA): (1) continue implementing PPACA, (2) do not apply title I of PPACA except to prohibit lifetime or annual limits on health insurance benefits and require coverage of dependents up to 26 years old, or (3) the second option plus implementation of a health savings account (HSA) deposit system.

In states implementing an HSA deposit system, residents who are enrolled in health insurance coverage that meets state standards receive monthly deposits in their HSAs either from states administering federal funds or as a tax credit paid in advance. States that administer deposits are entitled to payments from the Department of Health and Human Services for population health initiatives.

States with an HSA deposit system must offer a health insurance plan that is continually available for enrollment and penalize residents who have a break in coverage.

This bill amends title XIX (Medicaid) of the Social Security Act (SSAct) to disregard assets in an HSA for purposes of determining Medicaid eligibility and benefits except for long-term care services.

This bill amends SSAct title XVIII (Medicare) to require participating hospitals to limit costs to individuals for uncovered emergency medical care.

This bill amends the Internal Revenue Code to eliminate the requirement that an individual have a high deductible health plan to be eligible for the tax benefits of an HSA.

HSAs can be used to pay premiums for health insurance that meets specified requirements.

HSA tax benefits only apply to payments for health care for which the provider publishes the price.

patient freedom act bill provides states options title provisions health insurance reform exchanges subsidies patient_protection affordable care act ppaca continue implementing ppaca apply title ppaca prohibit lifetime annual limits health insurance benefits require coverage dependents years old second option plus implementation health savings account hsa deposit system states implementing hsa deposit system residents enrolled health insurance coverage meets state standards receive monthly deposits hsas states administering federal funds tax credit paid advance states administer deposits entitled payments department_of_health_and_human_services population health initiatives states hsa deposit system offer health insurance plan continually available enrollment penalize residents break coverage bill amends title xix medicaid social security act ssact disregard assets hsa purposes determining medicaid eligibility benefits long term care services bill amends ssact title xviii medicare require participating hospitals limit costs individuals uncovered emergency medical care bill amends internal_revenue_code eliminate requirement individual high deductible health plan eligible tax benefits hsa hsas pay premiums health insurance meets specified requirements hsa tax benefits apply payments health care provider publishes price


Summary:
Tax Free Health Insurance Act of 2015

Amends the Internal Revenue Code to allow an individual taxpayer a deduction from gross income of insurance premiums paid for the health care coverage of the taxpayer and the taxpayer's spouse and dependents. Makes such deduction available to taxpayers who do not otherwise itemize their deductions.

tax free health insurance act amends internal revenue code allow individual taxpayer deduction gross income insurance premiums paid health care coverage taxpayer taxpayer spouse dependents makes deduction available taxpayers itemize deductions


Summary:
Planning Actively for Cancer Treatment (PACT) Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of cancer care planning and coordination services.

planning actively cancer treatment pact act amends title xviii medicare social security act provide coverage cancer care planning coordination services


Summary:
Small Business Health Fairness Act of 2015

 Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for establishment and governance of association health plans (AHPs), which are group health plans whose sponsors are trade, industry, professional, chamber of commerce, or similar business associations, and which meet certain ERISA certification requirements.

Prescribes rules governing AHPs, including requirements relating to certification, sponsors and boards of trustees, participation and coverage, nondiscrimination, contribution rates, notice of voluntary termination, correction actions, and mandatory termination.

Establishes the Association Health Plan Fund to be used to make payments to an insurer to maintain coverage for a plan if there is a reasonable expectation that, without such payments, claims would not be satisfied by reason of termination of coverage.

Requires the Secretary of Labor to establish a Solvency Standards Working Group.

Allows a state to impose a contribution tax on an association health plan that commenced operations in such state after the enactment of this Act.

Preempts any state law that may preclude a health insurance issuer from: (1) offering health insurance coverage in connection with a certified AHP; or (2) offering health insurance coverage of the same policy type to other employers operating in the state that are eligible for coverage under such AHPs, whether or not such other employers are participating employers in such plan.

Subjects to criminal penalties a person who willfully makes false representations with respect to an AHP.

small_business_health_fairness_act amends employee retirement income security act erisa provide establishment governance association health plans ahps group health plans sponsors trade industry professional chamber commerce similar business associations meet certain erisa certification requirements prescribes rules governing ahps including requirements relating certification sponsors boards trustees participation coverage nondiscrimination contribution rates notice voluntary termination correction actions mandatory termination establishes_the_association_health_plan_fund payments insurer maintain coverage plan reasonable expectation payments claims satisfied reason termination coverage requires secretary labor establish allows state impose contribution tax association health plan commenced operations state enactment act preempts state law preclude health insurance issuer offering health insurance coverage connection certified ahp offering health insurance coverage policy type employers operating state eligible coverage ahps employers participating employers plan subjects criminal penalties person willfully makes false representations respect ahp


Summary:
Small Business Healthcare Relief Act

This bill amends the Internal Revenue Code and the Employee Retirement Income Security Act of 1974 (ERISA) to allow an employer with fewer than 50 employees that does not offer group health insurance coverage to establish a health reimbursement arrangement. Under the arrangement, funds contributed by an employer are excluded from the employer's taxable income and are used to pay or reimburse employees for medical care expenses, including premiums for individual health insurance coverage or Medicare supplemental insurance.

Such a reimbursement arrangement: (1) must not pay premiums for an employee covered by a family member's coverage, (2) must be offered to all eligible employees on the same terms and may only vary based on the number of individuals covered, and (3) is not required to provide continuation coverage.

Employer contributions to a reimbursement arrangement are not included in an employee's gross income if the employee was covered by the reimbursement arrangement for more than nine months of the year. Employees covered for less than nine months have a percentage of employer contributions included in their gross income, with exceptions.

An employee offered affordable individual health insurance coverage under a reimbursement arrangement is not eligible for a premium assistance tax credit.

Employers must report contributions to a reimbursement arrangement on their employees' W-2.

This bill amends the Public Health Service Act to exempt reimbursement arrangements from requirements for health insurance coverage. Insurance offered under a reimbursement arrangement remains subject to the requirements.

relief act bill amends internal_revenue_code employee retirement income security act erisa allow employer fewer employees offer group health insurance coverage establish health reimbursement arrangement arrangement funds contributed employer excluded employer taxable income pay reimburse employees medical care expenses including premiums individual health insurance coverage medicare supplemental insurance reimbursement arrangement pay premiums employee covered family member coverage offered eligible employees terms vary based number individuals covered required provide continuation coverage employer contributions reimbursement arrangement included employee gross income employee covered reimbursement arrangement months year employees covered months percentage employer contributions included gross income exceptions employee offered affordable individual health insurance coverage reimbursement arrangement eligible premium assistance tax credit employers report contributions reimbursement arrangement employees w-2 bill amends public_health_service_act exempt reimbursement arrangements requirements health insurance coverage insurance offered reimbursement arrangement remains subject requirements


Summary:
Veteran Continuity of Care Act

This bill amends the Veterans Access, Choice, and Accountability Act of 2014 to eliminate the 60-day limit on follow-up health care provided under the veterans choice program.

veteran continuity care act bill amends accountability act eliminate day limit follow health care provided veterans choice program


Summary:
Helping Save Americans' Health Care Choices Act of 2015

This bill amends the Internal Revenue Code, with respect to health savings accounts (HSAs), to:

 eliminate the requirement that a participant in an HSA be enrolled in a high deductible health care plan; increase the maximum contribution amount to an HSA; permit both spouses in an HSA to make catch-up contributions to the same account; allow the use of HSAs to pay health insurance premiums and long-term care insurance premiums; treat fees paid in advance for the right to receive medical services as a deductible medical expense; permit Medicare recipients to participate in HSAs; repeal the restriction on payments from HSAs for nonprescription drugs; repeal the additional tax on distributions from HSAs and Archer Medical Savings Accounts; and repeal the $2,500 limitation on salary reduction contributions to a health flexible spending arrangement under a cafeteria plan.

bill amends internal_revenue_code respect health savings accounts hsas eliminate requirement participant hsa enrolled high deductible health care plan increase maximum contribution hsa permit spouses hsa catch contributions account allow use hsas pay health insurance premiums long term care insurance premiums treat fees paid advance right receive medical services deductible medical expense permit medicare recipients participate hsas repeal restriction payments hsas nonprescription drugs repeal additional tax distributions hsas archer_medical_savings_accounts repeal limitation salary reduction contributions health flexible spending arrangement cafeteria plan


Summary:
Medicare Ventricular Assist Device Access Act of 2015

 Directs the Department of Health and Human Services (HHS) to revise the Medicare national coverage determination relating to coverage of ventricular assist devices to extend the coverage of such devices under title XVIII (Medicare) of the Social Security Act for individuals approved for heart transplantation to apply also to: (1) individuals undergoing an evaluation to determine candidacy for heart transplantation; and (2) individuals who would be heart transplant candidates, but are not so eligible because of a contraindication that may be favorably modified by the use of a ventricular assist device.

Directs HHS to use specified processes to revise its national coverage determination relating to ventricular assist devices to incorporate the requirements of this Act.

medicare assist device access act directs_the_department_of_health_and_human_services hhs revise medicare national coverage determination relating coverage assist devices extend coverage devices title xviii medicare social security act individuals approved heart transplantation apply individuals undergoing evaluation determine candidacy heart transplantation individuals heart transplant candidates eligible modified use assist device directs hhs use specified processes revise national coverage determination relating assist devices incorporate requirements act


Summary:
Better Enrollment Options Protect Employee Needs Act or the Be Open Act

This bill amends the Fair Labor Standards Act of 1938 to repeal the requirement that employers with more than 200 full-time employees that offer enrollment in one or more health benefits plans automatically enroll all new full-time employees in one of those plans.

employee needs act open act bill amends fair labor standards act repeal requirement employers time employees offer enrollment health benefits plans automatically enroll new time employees plans


Summary:
Fund Essential Menstruation Products Act of 2015 or the FEM Products Act of 2015

Amends the Internal Revenue Code to expand the tax exclusion for reimbursements from a health flexible spending arrangement to include amounts paid or incurred for feminine hygiene products.

fund essential products act products act amends internal revenue code expand tax exclusion reimbursements health flexible spending arrangement include amounts paid incurred hygiene products


Summary:
Youth Parity Act

This bill amends the Internal Revenue Code to allow the medical expenses of dependents who have not attained the age of 26 years before the close of the calendar year to be paid from a health savings account.

youth parity act bill amends internal_revenue_code allow medical expenses dependents attained age years close calendar year paid health savings account


Summary:
(This measure has not been amended since it was introduced. The summary has been expanded because action occurred on the measure.)

Veterans Emergency Treatment Act or the VET Act

(Sec. 1) This bill declares that, if a veteran who is enrolled in the Department of Veterans Affairs (VA) health care program requests a medical examination or treatment at an emergency department of a VA medical facility, the veteran shall be provided with:

 a medical screening examination to determine whether an emergency medical condition exists; and if an emergency condition exists, stabilizing medical treatment or transfer to another VA or non-VA medical facility. The VA is deemed to have met such requirements if it offers to transfer the veteran to another medical facility, informs the veteran of the transfer's risks and benefits, and the veteran refuses to consent to the transfer.

If a non-stabilized emergency medical condition exists the VA hospital may not transfer the veteran unless:

 the veteran (or individual), after being made aware of the risks, makes a written transfer request; a physician certifies that the medical benefits of a transfer outweigh the risks to the veteran and, in the case of a woman in labor, to the unborn child; if a physician is not present in the emergency department at the time of transfer, a qualified medical person has made such certification after a physician has determined that a transfer's benefit outweighs the risk and a physician subsequently countersigns the qualified medical person's certification; and the transfer is to a medical facility with the necessary treatment capacities. A VA or non-VA medical facility that has specialized capabilities or facilities (such as burn units, shock-trauma units, neonatal intensive care units, or, with respect to rural areas, regional referral centers) shall not refuse to accept a transfer if the facility has the capacity to treat the veteran.

A VA or non-VA medical facility may not delay a medical screening examination or further medical examination and treatment in order to inquire about a veteran's payment method or insurance status.

The VA may not take adverse action against a VA employee because the employee refuses to authorize the transfer of an enrolled veteran with a non-stabilized emergency medical condition or because the employee reports a violation of this bill.

measure amended introduced summary expanded action occurred measure veterans emergency treatment act vet act sec bill declares veteran enrolled department_of_veterans_affairs health care program requests medical examination treatment emergency department medical facility veteran shall provided medical screening examination determine emergency medical condition exists emergency condition exists stabilizing medical treatment transfer non-va medical facility deemed met requirements offers transfer veteran medical facility informs veteran transfer risks benefits veteran refuses consent transfer non emergency medical condition exists hospital transfer veteran veteran individual aware risks makes written transfer request physician certifies medical benefits transfer outweigh risks veteran case woman labor unborn child physician present emergency department time transfer qualified medical person certification physician determined transfer benefit outweighs risk physician subsequently qualified medical person certification transfer medical facility necessary treatment capacities non-va medical facility specialized capabilities facilities burn units trauma units neonatal intensive care units respect rural areas regional referral centers shall refuse accept transfer facility capacity treat veteran non-va medical facility delay medical screening examination medical examination treatment order inquire veteran payment method insurance status adverse action employee employee refuses authorize transfer enrolled veteran non emergency medical condition employee reports violation bill


Summary:
Providing Innovative Care for Complex Cases Demonstration Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to establish a pilot program to demonstrate improvements in patient care and cost savings for the highest-cost Medicare fee-for-service (FFS) beneficiaries through enrollment of such beneficiaries with participating organizations. The program shall be designed to provide comprehensive and integrated care management and services through a network of health care providers to meet the specialized needs of such beneficiaries. The Centers for Medicare & Medicaid Services (CMS) must design the program in such a manner as to preserve the operation of the Medicare prescription drug benefit.

A participating organization must meet the same requirements that apply to a Medicare Advantage (MA) organization. CMS must develop quality performance standards and, using an integrated care model, care management requirements for participating organizations.

For each individual enrolled under the program, CMS shall make a monthly capitated payment to the participating organization as would be made for an individual enrolled in an MA plan (excluding MA prescription drug plans), except that the amount of payment shall: (1) equal 98% of the projected cost under the Medicare FFS program for the highest-cost Medicare FFS beneficiaries; and (2) be adjusted to account for differences in costs among different geographic areas and among high-cost Medicare FFS beneficiaries, including outlier costs.

CMS must report to Congress on the performance of the program within two years of initial enrollment.

providing innovative care complex cases demonstration act bill amends title xviii medicare social security act establish pilot program demonstrate improvements patient care cost savings highest cost medicare fee service ffs beneficiaries enrollment beneficiaries participating organizations program shall designed provide comprehensive integrated care management services network health care providers meet specialized needs beneficiaries cms design program manner preserve operation medicare prescription drug benefit participating organization meet requirements apply organization cms develop quality performance standards integrated care model care management requirements participating organizations individual enrolled program cms shall monthly capitated payment participating organization individual enrolled plan excluding prescription drug plans payment shall equal projected cost medicare ffs program highest cost medicare ffs beneficiaries adjusted account differences costs different geographic areas high cost medicare ffs beneficiaries including outlier costs cms report congress performance program years initial enrollment


Summary:
Seniors Have Eyes, Ears, and Teeth Act

This bill amends title XVIII (Medicare) of the Social Security Act to expand Medicare coverage to include eyeglasses, hearing aids, and dental care.

seniors eyes teeth act bill amends title xviii medicare social security act expand medicare coverage include hearing aids dental care


Summary:
Timely Payment for Veterans' Medical Care Act

This bill authorizes the Department of Veterans Affairs (VA) to enter into contracts with an eligible entity to serve as an administrative contractor with respect to the performance of any or all of the following functions relating to providing medical care and hospital services in non-VA facilities:

 determining and making the payments required to be made to a non-VA facility; providing education and outreach to individuals enrolled in the patient enrollment system; providing consultative services to institutions, agencies, and other persons to enable them to maintain necessary fiscal records; communicating to non-VA facilities any information or instructions furnished to the administrative contractor by the VA; and performing functions relating to non-VA facility education, training, and technical assistance. An administrative contractor that performs such payment-related functions shall implement a contractor-wide information security program.

The VA shall use claims payment error rates or similar methodology of administrative contractors in the processing or reviewing of claims in order to give such contractors an incentive to implement effective education and outreach programs for non-VA facilities.

timely payment veterans medical care act bill authorizes department_of_veterans_affairs enter contracts eligible entity serve administrative contractor respect performance following functions relating providing medical care hospital services non-va facilities determining making payments required non-va facility providing education outreach individuals enrolled patient enrollment system providing consultative services institutions agencies persons enable maintain necessary fiscal records communicating non-va facilities information instructions furnished administrative contractor performing functions relating non-va facility education training technical assistance administrative contractor performs payment related functions shall implement contractor wide information security program shall use claims payment error rates similar methodology administrative contractors processing reviewing claims order contractors incentive implement effective education outreach programs non-va facilities


Summary:
Dental and Optometric Care Access Act or the DOC Access Act

This bill amends the Public Health Service Act to prohibit group health plans and individual health insurance coverage from setting rates for items and services provided by a doctor of optometry, of dental surgery, or of dental medicine for which the plan or insurer does not pay a substantial amount.

An agreement between a plan or insurer and such a doctor: (1) may only be changed with the doctor's acknowledgement and acceptance, and (2) may not last longer than two years if the agreement is for limited scope dental or vision benefits.

Such a doctor must be allowed to participate in a: (1) plan or coverage without accepting terms for ancillary services or procedures, and (2) provider network without participating in a specific limited scope dental or vision benefit plan.

Plans and insurers may not: (1) directly communicate with an enrolled individual in a manner that interferes with an existing doctor-patient relationship or a state or federal requirement, or (2) restrict such a doctor's choice of laboratories or suppliers.

The bill establishes a private right of action for a person adversely affected by a violation of this Act.

dental optometric care access act access act bill amends public_health_service_act prohibit group health plans individual health insurance coverage setting rates items services provided doctor optometry dental surgery dental medicine plan insurer pay substantial agreement plan insurer doctor changed doctor acknowledgement acceptance longer years agreement limited scope dental vision benefits doctor allowed participate plan coverage accepting terms ancillary services procedures provider network participating specific limited scope dental vision benefit plan plans insurers directly communicate enrolled individual manner interferes existing doctor patient relationship state federal requirement restrict doctor choice laboratories suppliers bill establishes private right action person adversely affected violation act


Summary:
State Health Care Options Act of 2015

This bill amends the Patient Protection and Affordable Care Act (PPACA) and the Internal Revenue Code to modify the process for state innovation waivers.

(Under current law, the Department of Health and Human Services [HHS] and the Department of the Treasury may approve a state's request to waive specific provisions of PPACA if the state proposal provides health care access that is comparable to what would exist without a waiver and does not increase the federal deficit.)

The bill expedites the approval process for:

 a health-flex waiver from requirements for qualified health plans and essential health benefits; and an exchange waiver to assume responsibility for certain functions of the exchanges, including the certification of permissible health plans. If a state submits to HHS a notice of its intent to implement one or both of the waivers, the waivers shall be deemed to be approved and effective. The notice must include the years for which the waiver shall be effective (which may be indefinite), an assurance the state will comply with reporting requirements, and other specified details.

A state may not waive PPACA requirements related to coverage for preexisting conditions and the extension of coverage for adult children.

States with exchange waivers may certify permissible health plans that residents may purchase outside of an exchange, if the plans meet specified requirements regarding benefits, levels of coverage, transparency of premium justifications, and information.

Taxpayers in waiver states that are living at or below 300% of the federal poverty level (400% under current law) may receive health insurance subsidies under PPACA.

act bill amends patient_protection affordable care act ppaca internal_revenue_code modify process state innovation waivers current law department_of_health_and_human_services hhs department_of_the_treasury approve state request waive specific provisions ppaca state proposal provides health care access comparable exist waiver increase federal deficit bill approval process health flex waiver requirements qualified health plans essential health benefits exchange waiver assume responsibility certain functions exchanges including certification permissible health plans state submits hhs notice intent implement waivers waivers shall deemed approved effective notice include years waiver shall effective indefinite assurance state comply reporting requirements specified details state waive ppaca requirements related coverage preexisting conditions extension coverage adult children states exchange waivers certify permissible health plans residents purchase outside exchange plans meet specified requirements benefits levels coverage transparency premium justifications information taxpayers waiver states living federal poverty level current law receive health insurance subsidies ppaca


Summary:
VA Billing Accountability Act

This bill authorizes the Department of Veterans Affairs (VA) to waive the requirement that a veteran make copayments for medications, hospital care, nursing home care, and medical services if:

 an error committed by the VA or a VA employee was the cause of delaying copayment notification to the veteran, and the veteran received such notification later than 120 days (18 months in the case of a non-VA facility) after the date on which the veteran received the care or services. In requiring a veteran to make a copayment for care or services provided at a VA or a non-VA medical facility the VA shall notify the veteran not later than 120 days (18 months in the case of a non-VA facility) after the date on which the veteran received the care or services. If the VA does not provide notification by such date it may not collect the payment, including through a third-party entity, unless the veteran is provided with:

 information about applying for a waiver and establishing a payment plan with the VA, and opportunity to make a waiver or establish a payment plan. The VA shall review and improve its copayment billing internal controls and notification procedures.

billing accountability act bill authorizes department_of_veterans_affairs waive requirement veteran copayments medications hospital care nursing home care medical services error committed employee cause delaying copayment notification veteran veteran received notification later days months case non-va facility date veteran received care services requiring veteran copayment care services provided non medical facility shall notify veteran later days months case non-va facility date veteran received care services provide notification date collect payment including party entity veteran provided information applying waiver establishing payment plan opportunity waiver establish payment plan shall review improve copayment billing internal controls notification procedures


Summary:
(This measure has not been amended since it was reported to the House on July 5, 2016. The summary of that version is repeated here.)

Halt Tax Increases on the Middle Class and Seniors Act

(Sec. 2) This bill amends the Internal Revenue Code to roll back the increased threshold for determining the amount of the tax deduction for medical expenses. Currently, individual taxpayers under age 65 may only deduct those medical expenses that exceed 10% of their adjusted gross income. This bill reduces that percentage to 7.5% for all taxpayers for tax years beginning after December 31, 2015.

The threshold percentage remains at 10% for purposes of computing the alternative minimum tax (AMT).

measure amended reported house july summary version repeated halt tax increases middle class seniors act sec bill amends internal_revenue_code roll increased threshold determining tax deduction medical expenses currently individual taxpayers age deduct medical expenses exceed adjusted gross income bill reduces percentage taxpayers tax years beginning december threshold percentage remains purposes computing alternative minimum tax amt


Summary:
HIV Clinical Services Improvement Act

This bill amends title XIX (Medicaid) of the Social Security Act to require payment under the Medicaid program for services furnished by recipients of Ryan White Part C grants, which support comprehensive primary care in outpatient settings for individuals living with HIV.

Providers must be paid an amount equivalent to the prior average costs of providing these services. However, a state plan may establish an alternative payment methodology that: (1) is agreed to by the state and the grantee, and (2) results in payment to the grantee that at least equals the amount otherwise required to be paid to the grantee under the bill.

As a condition of receiving payment under the bill, a grantee shall be subject to specified quality management and reporting requirements.

hiv clinical services improvement act bill amends title xix medicaid social security act require payment medicaid program services furnished recipients ryan_white grants support comprehensive primary care outpatient settings individuals living hiv providers paid equivalent prior average costs providing services state plan establish alternative payment methodology agreed state grantee results payment grantee equals required paid grantee bill condition receiving payment bill grantee shall subject specified quality management reporting requirements


Summary:
Medicare Premium Fairness Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to: (1) prevent 2016 increases to Medicare Part B premiums and deductibles for enrollees, and (2) authorize federal funding to offset the corresponding reduction in aggregate monthly premiums.

Under current law, the Centers for Medicare & Medicaid Services must annually determine the monthly actuarial rate upon which Part B premiums and deductibles are based. The bill temporarily freezes that rate at the 2015 level for enrollees, effectively preventing increases to premiums and deductibles for those enrollees in 2016. (Current law already protects Part B enrollees whose benefits are deducted from their Social Security benefits from premium increases that would result in a smaller Social Security check.)

medicare premium fairness act bill amends title xviii medicare social security act prevent increases medicare premiums deductibles enrollees authorize federal funding offset corresponding reduction aggregate monthly premiums current law annually determine monthly actuarial rate premiums deductibles based bill temporarily freezes rate level enrollees effectively preventing increases premiums deductibles enrollees current law protects enrollees benefits deducted social_security benefits premium increases result smaller social_security check


Summary:
Access to Marketplace Insurance Act

This bill amends the Patient Protection and Affordable Care Act to require health insurers to accept, on behalf of individuals enrolled in qualified health plans, payments made by certain third parties, including state and federal government programs, Indian tribes, tribal organizations, urban Indian organizations, and certain tax exempt organizations. (Qualified health plans are eligible for subsidies and fulfill an individual's requirement to maintain minimum essential coverage.)

access marketplace insurance act bill amends patient_protection affordable care act require health insurers accept behalf individuals enrolled qualified health plans payments certain parties including state federal government programs indian tribes tribal organizations urban indian organizations certain tax exempt organizations qualified health plans eligible subsidies fulfill individual requirement maintain minimum essential coverage


Summary:
Medicaid Directory of Caregivers Act or the Medicaid DOC Act

(Sec. 2) This bill amends title XIX (Medicaid) of the Social Security Act to require a state to publish and annually update a directory of providers that participate in the state plan for medical assistance on a fee-for-service basis or through a primary care case-management system. The directory must include each provider's name, specialty, address, and telephone number. In addition, with respect to a provider that participates in a primary care case-management system, the directory must specify: (1) the provider's language capabilities, and (2) whether the provider is accepting new Medicaid patients.

medicaid act sec bill amends title xix medicaid social security act require state publish annually update directory providers participate state plan medical assistance fee service basis primary care case management system directory include provider specialty address telephone number addition respect provider participates primary care case management system directory specify provider language capabilities provider accepting new medicaid patients


Summary:
(This measure has not been amended since it was passed by the House on December 10, 2015. The summary of that version is repeated here.)

Securing Fairness in Regulatory Timing Act of 2015

(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act to extend from 45 days to 60 days the annual notice period for the announcement of payment rates under Medicare Advantage (MA). MA organizations shall have at least 30 days to comment on proposed changes.

measure amended passed house december summary version repeated securing fairness regulatory timing act sec bill amends title xviii medicare social security act extend days days annual notice period announcement payment rates medicare_advantage organizations shall days comment proposed changes


Summary:
Veterans Affairs Transfer of Information and Sharing of Disability Examination Procedures with DOD Doctors Act

This bill declares that:

 if a member of the Armed Forces who is required to receive a physical examination as part of his or her separation from active duty has or is believed to have a medical condition that will or may make the member eligible for Department of Veterans Affairs (VA) disability compensation and benefits, the physical examination shall be performed by a VA-certified health care provider; and if such a condition is discovered during the physical examination and the examining health care provider is not VA-certified, the examination shall be completed by a VA-certified health care provider. An eligibility determination made as part of such physical examination shall be binding on the VA and be used as the basis for assigning the member's disability rating.

The VA and the Department of Defense shall jointly establish a system to share data and maintain the medical and personnel records of members of the Armed Forces and veterans.

veterans affairs transfer information sharing disability examination procedures dod doctors act bill declares member armed_forces required receive physical examination separation active duty believed medical condition member eligible department_of_veterans_affairs disability compensation benefits physical examination shall performed certified health care provider condition discovered physical examination examining health care provider certified examination shall completed certified health care provider eligibility determination physical examination shall binding basis assigning member disability rating department_of_defense shall jointly establish system share data maintain medical personnel records members armed_forces veterans


Summary:
Camp Lejeune Reservist Parity Act of 2015

This bill makes certain members or former members of an Armed Forces reserve component who received training at Camp Lejeune, North Carolina, eligible for Department of Veterans Affairs hospital care and medical services.

The Government Accountability Office shall study the access to hospital care and medical services of veterans and family members stationed at Camp Lejeune, North Carolina.

camp lejeune reservist parity act bill makes certain members members armed_forces reserve component received training camp lejeune north_carolina eligible department_of_veterans_affairs hospital care medical services government_accountability_office shall study access hospital care medical services veterans family members stationed camp lejeune north_carolina


Summary:
Veterans Freedom of Healthcare Act

This bill amends the Veterans Access, Choice, and Accountability Act of 2014 to make the Department of Veterans Affairs (VA) Choice Program permanent. (The program allows the furnishing of hospital care and medical services to eligible veterans through agreements with non-VA entities.)

Program eligibility requirements are revised.

 The VA shall ensure that veterans enrolled in the health care system, particularly those with service-connected disabilities rated 50% or greater, are able to receive:

 health care at VA medical facilities within certain wait-time goals; and the highest degree of care possible, with an emphasis on maintaining the highest degree of quality in treating ailments unique to or prevalent among the veteran population, including mental health services.

healthcare act bill amends accountability act department_of_veterans_affairs permanent program allows furnishing hospital care medical services eligible veterans agreements non-va entities program eligibility requirements revised shall ensure veterans enrolled health care system particularly service connected disabilities rated greater able receive health care medical facilities certain wait time goals highest degree care possible emphasis maintaining highest degree quality treating unique prevalent veteran population including mental health services


Summary:
Obamacare Full Disclosure Act

This bill requires a form provided by the Center for Medicare and Medicaid Services to group health plans and health insurers as a template for a cancellation notice to include specified information under specified circumstances. The form must include a statement that an enrollee's plan or coverage was cancelled because of the Patient Protection and Affordable Care Act (PPACA) if the plan or coverage was cancelled because it did not meet PPACA requirements or because of financial losses incurred due to PPACA requirements.

obamacare disclosure act bill requires form provided medicaid_services group health plans health insurers template cancellation notice include specified information specified circumstances form include statement enrollee plan coverage cancelled patient_protection affordable care act ppaca plan coverage cancelled meet ppaca requirements financial losses incurred ppaca requirements


Summary:
Health Care Choices for Seniors Act

This bill amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act (SSAct) to require the Department of Health and Human Services (HHS) to establish the Medicare Alternative Voucher (MAV) Program, under which a voucher may be used as a contribution into a health savings account and for the payment of enrollment premiums under a high-deductible health plan. HHS must establish a procedure under which an individual otherwise entitled to benefits under part A (Hospital Insurance) of title XVIII (Medicare) of the SSAct may waive such entitlement and be automatically enrolled in the MAV Program.

In addition, the bill amends the Internal Revenue Code to increase the amount of the deduction from gross income for health savings accounts by the amount of the MAV that is contributed to an individual's health savings account.

The bill also suspends Medicare late enrollment penalties for an individual between ages 65 and 70.

bill amends title old age survivors disability insurance oasdi social security act ssact require department_of_health_and_human_services hhs establish program voucher contribution health savings account payment enrollment premiums high deductible health plan hhs establish procedure individual entitled benefits title xviii medicare ssact waive entitlement automatically enrolled addition bill amends internal_revenue_code increase deduction gross income health savings accounts contributed individual health savings account bill suspends medicare late enrollment penalties individual ages


Summary: This bill directs the Department of Veterans Affairs (VA) to study the feasibility of entering into covered public-private partnerships to improve the access of veterans to VA medical facilities in densely populated communities and rural communities.

bill directs department_of_veterans_affairs study feasibility entering covered public private partnerships improve access veterans medical facilities populated communities rural communities


Summary: This bill amends the Internal Revenue Code to exclude any amount includible in gross income for converting to a Roth Individual Retirement Account from the calculation of adjusted gross income used to determine eligibility for, and the amount of, the tax credit for health care insurance premium assistance.

bill amends internal_revenue_code exclude includible gross income converting roth individual retirement account calculation adjusted gross income determine eligibility tax credit health care insurance premium assistance


Summary:
Medicare Advantage Bill of Rights Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to establish limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required.

An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements.

The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required.

Sanctions for noncompliance with the bill's requirements apply.

bill amends title xviii medicare social security act establish limits removal medicare_advantage providers organizations days day annual coordinated election period plan organization remove provider plan provider medically negligent violation legal contractual requirement unfit furnish items services required organization remove provider plan completion fair notice appeal process additionally organization provide written notification removal enrollee receiving items services provider ensure removal satisfies certain continuity care requirements bill establishes network adequacy requirements specifically establishing plan network organization shall consider specified factors related provider availability timely provision care furthermore organization annually certify centers providers plan networks able provide services meet enrollees needs required sanctions noncompliance bill requirements apply


Summary:
Medicare Advantage Quality Payment Relief Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare & Medicaid to disregard the application of certain percentage quality increases when calculating the maximum payment that may be made to a Medicare Advantage organization.

bill amends title xviii medicare social security act require centers disregard application certain percentage quality increases calculating maximum payment medicare_advantage organization


Summary:
Patient Opportunity Protection Act of 2015

This bill amends the Public Health Service Act to prohibit the Department of Health and Human Services (HHS) from imposing additional conditions on excepted benefits, which are health benefits that are not subject to requirements applicable to group health plans or individual health insurance.

In the individual health insurance market, HHS may not condition the treatment of fixed indemnity insurance as an excepted benefit on the beneficiary satisfying the requirement for minimum essential coverage.

The amendments made by this bill are retroactively effective as if included in the Patient Protection and Affordable Care Act.

patient opportunity protection act bill amends public_health_service_act prohibit department_of_health_and_human_services hhs imposing additional conditions excepted benefits health benefits subject requirements applicable group health plans individual health insurance individual health insurance market hhs condition treatment fixed indemnity insurance excepted benefit beneficiary satisfying requirement minimum essential coverage amendments bill retroactively effective included patient_protection affordable care act