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House Bill 5212
116th Congress(2019-2020)
Accountable Care in Rural America Act
Introduced
Introduced
Introduced in House on Nov 21, 2019
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Introduced in House 
Nov 21, 2019
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Introduced in House(Nov 21, 2019)
Nov 21, 2019
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H. R. 5212 (Introduced-in-House)


116th CONGRESS
1st Session
H. R. 5212


To amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program.

IN THE HOUSE OF REPRESENTATIVES

November 21, 2019

Mr. Arrington (for himself, Ms. DelBene, Mr. Marshall, and Mr. Bera) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. Short title.

This Act may be cited as the “Accountable Care in Rural America Act”.

SEC. 2. Exclusion of Medicare fee-for-service beneficiaries assigned to an ACO from aspects of other payment models in certain circumstances including determination of regional adjustments.

Section 1899(i)(3) of the Social Security Act (42 U.S.C. 1395jjj(i)(3)) is amended—

(1) in subparagraph (A), by striking “subparagraph (B)” and inserting “subparagraphs (B) and (C)”; and

(2) by adding at the end the following new subparagraph:

    “(C) EXCLUSION OF ASSIGNED BENEFICIARIES IN CERTAIN CIRCUMSTANCES INCLUDING DETERMINATION OF REGIONAL ADJUSTMENTS.—For performance periods beginning on or after the date of the enactment of this subparagraph, in determining any shared savings for any ACO under a model described in this paragraph, the Secretary shall—

    “(i) remove Medicare fee-for-service beneficiaries who are assigned to that ACO from the methodology for calculating regional expenditures used to establish, update, and adjust the benchmark expenditures; and

    “(ii) otherwise ensure that no such ACO is in a less favorable financial position due to differences between the share of Medicare fee-for-service beneficiaries assigned to the ACO of all such beneficiaries in the counties an ACO operates in compared to the share of such beneficiaries assigned to other ACOs.”.