H.R. 2505, Medicare Advantage Coverage Transparency Act of 2015, as amended

H.R. 2505

Medicare Advantage Coverage Transparency Act of 2015, as amended

Sponsor
Rep. Mike Kelly

Committee
Ways and Means

Date
June 17, 2015 (114th Congress, 1st Session)

Staff Contact
John Huston

Floor Situation

On Wednesday, June 17, 2015, the House will consider H.R. 2505, Medicare Advantage Coverage Transparency Act of 2015, under suspension of the rules.  H.R. 2505 was introduced on May 21, 2015, by Rep. Mike Kelly (R-PA) and was referred to the Committee on Ways and Means, and in addition, to the Committee on Energy and Commerce. The Committee on Ways and Means ordered the bill reported, as amended, by voice vote on June 2, 2015.

Bill Summary

H.R. 2505, as amended, requires the Secretary of the Department of Health and Human Services to report Medicare enrollment information by zip code, congressional district, and state to congressional committees in the House and Senate with jurisdiction over the Medicare program by May 1 each year. The bill also requires the Secretary to notify these committees when the required report cannot be submitted by the prescribed deadline and explain the inability to provide such report.

Background

“Medicare Advantage (MA) is an alternative way for Medicare beneficiaries to receive covered health care benefits. Under MA, private health plans are paid a per-person amount to provide all Medicare-covered benefits (except hospice) to beneficiaries who enroll in their plan. Eligible individuals may enroll in an MA plan, if one is available in their area. Unlike under original Medicare, where providers are paid for each item or service provided to a beneficiary, the same capitated monthly payment is made to an MA plan regardless of how many or few services a beneficiary actually uses.” This program has led to increased choice of medical services for seniors.[1]  CMS does not currently publically report Medicare enrollment data by zip code or congressional district.

According to the bill sponsor, “In 2014, the majority of the 54 million people on Medicare were in the traditional Medicare program, with 30 percent enrolled in Medicare Advantage plans. . . This legislation will give all of us, including me, the ability to know more information about how changes in Medicare Advantage plans in Washington will impact our constituents and our districts back home.”[2]

_______________
[1] See CRS Report “Medicare Advantage—Proposed Benchmark Update and Other Adjustments for CY2016: In Brief,” February 25, 2015.
[2] See Rep. Mike Kelly Press Release, June 2, 2015.

Cost

The Congressional Budget Office (CBO) estimates enacting H.R. 2505 will not have a significant budgetary effect.

Additional Information

For questions or further information please contact John Huston with the House Republican Policy Committee by email or at 6-5539.