Summary:
Behavioral Health Information Technology Coordination Act of 2013 - Amends the Public Health Service Act to include as health care providers behavioral and mental health professionals, substance abuse professionals, psychiatric hospitals, certain community mental health centers, and residential or outpatient mental health or substance abuse treatment facilities.

Amends title XVIII (Medicare) of the Social Security Act (SSA), with respect to incentives for meaningful use of certified electronic health records (EHR) technology under the pay schedule for physician's services, to include as additional eligible professionals clinical psychologists providing qualified psychologist services. Subjects any additional eligible professionals, including those under a MedicareAdvantage (MA) plan, to reductions in incentive payments after a certain date for failure to be a meaningful EHR user.

Makes inpatient psychiatric hospitals eligible for payment for inpatient hospital services.

Amends SSA title XIX (Medicaid) to treat as Medicaid providers: (1) public and certain private hospitals that are principally psychiatric hospitals, (2) certain community mental health centers, and (3) certain residential or outpatient mental health or substance abuse treatment facilities.

Makes eligible professionals under the Medicaid program certain clinical psychologists providing qualified psychologist services.

Authorizes a covered entity to submit to a patient safety organization information on electronic health record (EHR)-related adverse events with respect to certified EHR technology.

Specifies covered entities as certain EHR users, health information exchange entities, and health care professionals who use EHR technology.

Defines an EHR-related adverse event as a defect, malfunction, or error in the certified health information technology or EHR used by a provider, or in the input or output of data maintained through such technology or record, that results or could reasonably result in harm to a patient.

Limits electronic discovery (e-discovery) in any health care lawsuit against a covered entity relating to an Reallotted adverse event involving certified EHR technology to information: (1) related to that event, and (2) from the period in which the event occurred.

Prohibits a claimant from commencing a lawsuit more than three years after the manifestation of injury or one year after the claimant discovers, or should have discovered, the injury, whichever occurs first. Requires tolling of this limitation, however, to the extent that the claimant is able to prove: (1) fraud; (2) intentional concealment; or (3) the presence of a foreign body, with no therapeutic or diagnostic purpose or effect, in the injured person.

Subjects each party to such a lawsuit which is not a covered entity to proportionate liability only.

Allows punitive damages against a covered entity only upon proof by clear and convincing evidence that the entity acted with reckless disregard for the claimant's health or safety.

Shields covered entities, employees, agents, and representatives from civil liability for libel or slander arising from information or entries made in certified EHR technology, or transferred to another eligible provider, if the information, entries, or transfer were made in good faith and without malice.

behavioral health information technology coordination act amends public_health_service_act include health_care providers behavioral mental health professionals substance abuse professionals psychiatric hospitals certain community mental health centers residential outpatient mental health substance abuse treatment facilities amends title xviii medicare social_security_act ssa respect incentives meaningful use certified electronic health records ehr technology pay schedule physician services include additional eligible professionals clinical psychologists providing qualified psychologist services subjects additional eligible professionals including medicareadvantage plan reductions incentive payments certain date failure meaningful ehr user makes inpatient psychiatric hospitals eligible payment inpatient hospital services amends ssa title xix medicaid treat medicaid providers public certain private hospitals principally psychiatric hospitals certain community mental health centers certain residential outpatient mental health substance abuse treatment facilities makes eligible professionals medicaid program certain clinical psychologists providing qualified psychologist services authorizes covered entity submit patient safety organization information electronic health record adverse events respect certified ehr technology specifies covered entities certain ehr users health information exchange entities health_care professionals use ehr technology defines ehr related adverse event defect error certified health information technology ehr provider input output data maintained technology record results reasonably result harm patient limits electronic discovery discovery health_care lawsuit covered entity relating adverse event involving certified ehr technology information related event period event occurred prohibits claimant commencing lawsuit years manifestation injury year claimant discovers discovered injury whichever occurs requires tolling limitation extent claimant able prove fraud intentional concealment presence foreign body therapeutic diagnostic purpose effect injured person subjects party lawsuit covered entity proportionate liability allows punitive damages covered entity proof clear convincing evidence entity acted reckless disregard claimant health safety shields covered entities employees agents representatives civil liability libel slander arising information entries certified ehr technology transferred eligible provider information entries transfer good faith malice


Summary:
Fair Competition for Hospitals Act of 2013 - Requires the wage index applying to a certain kind of subsection (d) hospital under title XVIII (Medicare) of the Social Security Act to be the highest wage index assigned to hospitals in the core-based statistical area in which the hospital is located (regardless of which state the hospital is located in) as a result of the requirement of the Balanced Budget Act of 1997 that the area wage index applicable to any hospital which is not located in a rural area be not less than the area wage index applicable to hospitals located in rural areas in the state in which the hospital is located.

(Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

Limits the application of this Act to a subsection (d) hospital: (1) located in a core-based statistical area comprising counties from more than one state, but (2) not located in a core-based statistical area in which one or more hospitals are subject to a specified minimum wage index, and (3) not located in a core-based statistical area in which the highest wage index applies to hospitals covered by this Act under a state Medicare reimbursement system.

fair competition hospitals act requires wage index applying certain kind subsection hospital title xviii medicare social_security_act highest wage index assigned hospitals core based statistical area hospital located regardless state hospital located result requirement balanced_budget act area wage index applicable hospital located rural area area wage index applicable hospitals located rural areas state hospital located generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system ipps providing covered inpatient services eligible beneficiaries limits application act subsection hospital located core based statistical area comprising counties state located core based statistical area hospitals subject specified minimum wage index located core based statistical area highest wage index applies hospitals covered act state medicare reimbursement system


Summary:
(This measure has not been amended since it was introduced. The summary of that version is repeated here.)

Directs the Secretary of Health and Human Services (HHS), to continue to apply through calendar year 2014 the enforcement instruction on physician supervision requirements for outpatient therapeutic services in critical access and small rural hospitals, as extended in November 2012 for calendar year 2013 by the Centers for Medicare & Medicaid Services. (The instruction directs Medicare contractors not to evaluate or enforce such requirements until the policy on supervision of such services could be revisited.)

measure amended introduced summary version repeated directs secretary health_and_human_services hhs continue apply calendar year enforcement instruction physician supervision requirements outpatient therapeutic services critical access small rural hospitals extended november calendar year centers medicare medicaid_services instruction directs medicare contractors evaluate enforce requirements policy supervision services


Summary:
Authorizes the Secretary of Veterans Affairs (VA) to enter into an enhanced-use lease for buildings 205 and 208 of the West Los Angeles Medical Center, California, for the provision of long-term therapeutic housing for homeless veterans who require assisted living or other similar forms of care. Exempts such buildings from a provision authorizing the Secretary to transfer property under an enhanced-use lease to the lessee.

Requires the Secretary to: (1) review such lease at least once during each two-year period in which it is in effect, including by assessing the leasing party and determining whether such lease should continue; and (2) submit a report.

authorizes secretary veterans_affairs enter enhanced use lease buildings west los_angeles medical center california provision long term therapeutic housing homeless veterans require assisted living similar forms care exempts buildings provision authorizing secretary transfer property enhanced use lease lessee requires secretary review lease year period effect including assessing leasing party determining lease continue submit report


Summary:
Consumer Learning through Electronically-Accessible and Reasonable Cost Information Act of 2013 [sic] or CLEAR Cost Information Act of 2013 [sic] - Amends title XVIII (Medicare) of the Social Security Act (SSA) to require service providers, in order to be qualified to participate and receive Medicare payments under any agreement filed with the Secretary of Health and Human Services (HHS), to report to the Secretary payment data on "subsection (d) hospitals."

(Generally, a subsection (d) hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system when providing covered inpatient services to eligible beneficiaries.)

Requires a subsection (d) hospital to submit to the Secretary data on the actual amounts it has collected from uninsured and insured patients over the preceding two years for each of the 50 most common diagnosis-related groups and ambulatory payment classification groups for which payment is made in both the inpatient and outpatient settings.

Requires each annual report submitted to Congress by the Medicare Payment Advisory Commission (MEDPAC) to contain information on the percentage that charity care makes up of the total care furnished by hospitals and critical access hospitals.

Amends the Patient Protection and Affordable Care Act to require the Secretary of the Treasury to post data on trends in the levels of charity care provided by certain hospitals on a publicly accessible and searchable website. Amends SSA title XVIII to require hospitals and critical access hospitals to include a link to such data on their home Internet websites.

consumer learning electronically accessible reasonable cost information act sic clear cost information act sic amends title xviii medicare social_security_act ssa require service providers order qualified participate receive medicare payments agreement filed secretary health_and_human_services hhs report secretary payment data subsection hospitals generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system providing covered inpatient services eligible beneficiaries requires subsection hospital submit secretary data actual amounts collected uninsured insured patients preceding years common diagnosis related groups ambulatory payment classification groups payment inpatient outpatient settings requires annual report submitted congress medicare_payment_advisory_commission medpac contain information percentage charity care makes total care furnished hospitals critical access hospitals amends patient_protection affordable care act require secretary treasury post data trends levels charity care provided certain hospitals publicly accessible searchable website amends ssa title xviii require hospitals critical access hospitals include link data home internet websites


Summary:
Preventing Regulatory Overreach To Enhance Care Technology Act of 2014 or the PROTECT Act of 2014 - Expresses the sense of Congress concerning:

 interagency coordination to foster health information technology and mobile health innovation, development of legislation to establish a risk-based regulatory framework for clinical software and health software, oversight by the National Institute of Standards and Technology (NIST) of technical standards used by clinical software, and work by NIST on next steps regarding health information technology, such as collaborating with nongovernmental entities to develop certification processes and to promote best practice standards. Excepts clinical software and health software from regulation under the Federal Food, Drug, and Cosmetic Act and excludes the terms from the meaning of "device."

Defines "clinical software" as clinical decision support software or other software intended for human or animal use that: (1) captures, analyzes, changes, or presents patient or population clinical data or information and may recommend courses of clinical action, but does not directly change the structure or any function of the body; and (2) is intended to be marketed for use only by a health care provider in a health care setting.

 Defines "health software" as software: (1) that captures, analyzes, changes, or presents patient or population clinical data or information; (2) that supports administrative or operational aspects of health care and is not used in the direct delivery of patient care; or (3) whose primary purpose is to act as a platform for a secondary software, to run or act as a mechanism for connectivity, or to store data.

preventing regulatory overreach enhance care technology act protect act expresses sense congress concerning interagency coordination foster health information technology mobile health innovation development legislation establish risk based regulatory framework clinical software health software oversight national_institute_of_standards_and_technology nist technical standards clinical software work nist steps health information technology collaborating nongovernmental entities develop certification processes promote best practice standards excepts clinical software health software regulation federal food drug cosmetic act excludes terms meaning device defines clinical software clinical decision support software software intended human animal use captures analyzes changes presents patient population clinical data information recommend courses clinical action directly change structure function body intended marketed use health_care provider health_care setting defines health software software captures analyzes changes presents patient population clinical data information supports administrative operational aspects health_care direct delivery patient care primary purpose act platform secondary software run act mechanism connectivity store data


Summary:
Two-Midnight Rule Coordination and Improvement Act of 2014 - Directs the Secretary of Health and Human Services (HHS) to develop appropriate criteria with regard to the two-midnight rule for payment under title XVIII (Medicare) of the Social Security Act for a short inpatient hospital stay.

(The two-midnight rule allows Medicare coverage of only hospital stays for which a physician admits to a hospital a beneficiary expected to require care that crosses two midnights, but generally denies coverage of care expected to require less than a two-midnight stay.)

Requires the criteria developed by the Secretary to: (1) account for medical necessity and the appropriateness of an inpatient stay that is less than the two-midnight benchmark, and (2) be developed in consultation with interested stakeholders.

Directs the Secretary to develop a budget-neutral Medicare payment methodology for hospitals for short inpatient hospital stays.

Allows the methodology to be: (1) a reduced payment amount than would otherwise apply to inpatient hospital services if paid for under the Medicare prospective payment schedule, or (2) an alternative payment methodology.

Directs the Secretary to develop: (1) general equivalency maps to link the relevant International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes (used to report medical diagnoses and inpatient procedures) to relevant Current Procedural Terminology (CPT) codes, and the relevant CPT codes to relevant ICD-10 codes, in order to permit comparison of inpatient hospital services and hospital outpatient department services; and (2) a second crosswalk between Diagnosis-Related Group (DRG) codes for inpatient hospital services and Ambulatory Payment Class (APC) codes for outpatient hospital services.

Prohibits the Secretary from enforcing the two-midnight rule for admissions occurring: (1) before October 1, 2014; and (2) on or after that date until October 1, 2015, or the new two-midnight rule criteria are implemented, if sooner (applicable date).

Prohibits a Medicare review contractor from denying a claim for inpatient hospital services furnished by a hospital, or inpatient critical access hospital services furnished by a critical access hospital, on the basis of the two-midnight rule for discharges occurring before the applicable date for: (1) medical necessity due to the length of an inpatient stay in such hospital or due to a determination that the services could have been provided on an outpatient basis; or (2) requirements for orders, certifications, or recertifications, and associated documentation relating to such matters.

Declares that nothing in this Act shall be construed to preclude the Secretary from continuing the conduct by Medicare administrative contractors of the Medicare Probe and Educate program for hospital admissions during the delayed enforcement of the two-midnight rule.

Prohibits the Secretary from increasing the sample of claims selected for prepayment review under the Medicare Probe and Educate program above the number and type established by the Secretary as of November 4, 2013, such as 10 claims for most hospitals and 25 claims for large hospitals.

midnight rule coordination improvement act directs secretary health_and_human_services hhs develop appropriate criteria regard midnight rule payment title xviii medicare social_security_act short inpatient hospital stay midnight rule allows medicare coverage hospital stays physician hospital beneficiary expected require care crosses generally denies coverage care expected require midnight stay requires criteria developed secretary account medical necessity appropriateness inpatient stay midnight benchmark developed consultation interested stakeholders directs secretary develop budget neutral medicare payment methodology hospitals short inpatient hospital stays allows methodology reduced payment apply inpatient hospital services paid medicare prospective payment schedule alternative payment methodology directs secretary develop general equivalency maps link relevant international statistical classification diseases related health problems codes report medical diagnoses inpatient procedures relevant current procedural terminology cpt codes relevant cpt codes relevant icd-10 codes order permit comparison inpatient hospital services hospital outpatient department services second diagnosis related group codes inpatient hospital services ambulatory payment class codes outpatient hospital services prohibits secretary enforcing midnight rule admissions occurring october date october new midnight rule criteria implemented sooner applicable date prohibits medicare review contractor denying claim inpatient hospital services furnished hospital inpatient critical access hospital services furnished critical access hospital basis midnight rule discharges occurring applicable date medical necessity length inpatient stay hospital determination services provided outpatient basis requirements orders certifications associated documentation relating matters declares act shall construed preclude secretary continuing conduct medicare administrative contractors medicare educate program hospital admissions delayed enforcement midnight rule prohibits secretary increasing sample claims selected prepayment review medicare educate program number type established secretary november claims hospitals claims large hospitals


Summary:
Veterans Health Care Access Received Closer to Home Act of 2014 - Expresses the sense of Congress in support of veteran-centric health care coordination between the Department of Veterans Affairs (VA) and community providers, as well as cost-effective VA purchase of veterans' care from the private sector.

Amends the Veterans' Mental Health and Other Care Improvements Act of 2008 to reauthorize a VA pilot program of contract care authority within specified Veterans Integrated Service Networks for the health care needs of veterans in highly rural areas who are enrolled in the VA annual patient enrollment system. Requires: (1) that medical appointments for veterans, under the pilot program, occur during the 30-day period beginning on the date that is 15 days after the appointment is requested, and (2) the Secretary of Veterans Affairs to ensure that eligible veterans are informed of the program.

veterans health_care access received home act expresses sense congress support veteran health_care coordination department_of_veterans_affairs community providers cost effective purchase veterans care private sector amends veterans mental health care improvements act reauthorize pilot program contract care authority specified veterans_integrated_service_networks health_care needs veterans highly rural areas enrolled annual patient enrollment system requires medical appointments veterans pilot program occur day period beginning date days appointment requested secretary veterans_affairs ensure eligible veterans informed program


Summary: Rural Community Hospital Demonstration Extension Act of 2014 - Amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, as amended by the Patient Protection and Affordable Care Act, to extend the rural community hospital demonstration program from five through 10 years.

rural community hospital demonstration extension act amends medicare_prescription_drug improvement modernization act amended patient_protection affordable care act extend rural community hospital demonstration program years


Summary:
Requires the Inspector General of the Department of Veterans Affairs (VA) to submit to Congress within 180 days after enactment of this Act a report on wait times for veterans seeking medical appointments and treatment from the VA, which shall include: (1) information on wait times throughout the United States, and (2) a determination by the Inspector General as to whether such wait times have been prolonged by VA employees without a valid medical or administrative reason.

Prohibits the VA Secretary from closing any VA medical facility, or from using any VA funds to prepare any environment impact statement related to such closure, before such report is submitted, or after the report is submitted if the Inspector General determines that wait times have been prolonged by VA employees without a valid reason, unless the Secretary certifies that such closure will not:

 increase the wait times for veterans in the catchment area of such medical facility; decrease the quality of care provided to such veterans; impede the access of such veterans to specialized health care services or to VA residential rehabilitation treatment programs and other inpatient care; increase the distance required to be traveled by such veterans to receive care; or impede the access to medical care for such veterans that are members of Indian tribes. Terminates such prohibition when the Inspector General certifies that such wait times are not being prolonged by VA employees without a valid reason.

requires inspector_general department_of_veterans_affairs submit congress days enactment act report wait times veterans seeking medical appointments treatment shall include information wait times united_states determination inspector_general wait times prolonged employees valid medical administrative reason prohibits secretary closing medical facility funds prepare environment impact statement related closure report submitted report submitted inspector_general determines wait times prolonged employees valid reason secretary certifies closure increase wait times veterans area medical facility decrease quality care provided veterans impede access veterans specialized health_care services residential rehabilitation treatment programs inpatient care increase distance required traveled veterans receive care impede access medical care veterans members indian tribes terminates prohibition inspector_general certifies wait times prolonged employees valid reason


Summary:
Registered Nurse Safe Staffing Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to require each Medicare participating hospital to implement a hospital-wide staffing plan for nursing services furnished in the hospital.

Requires the plan to require that an appropriate number of registered nurses provide direct patient care in each unit and on each shift of the hospital to ensure staffing levels that: (1) address the unique characteristics of the patients and hospital units; and (2) result in the delivery of safe, quality patient care consistent with specified requirements.

Requires each participating hospital to establish a hospital nurse staffing committee which shall implement such plan.

Specifies civil monetary and other penalties for violation of the requirements of this Act.

Sets forth whistleblower protections against discrimination and retaliation involving patients or employees of the hospital for their grievances, complaints, or involvement in investigations relating to such plan.

registered nurse safe staffing act amends title xviii medicare social_security_act require medicare participating hospital implement hospital wide staffing plan nursing services furnished hospital requires plan require appropriate number registered nurses provide direct patient care unit shift hospital ensure staffing levels address unique characteristics patients hospital units result delivery safe quality patient care consistent specified requirements requires participating hospital establish hospital nurse staffing committee shall implement plan specifies civil monetary penalties violation requirements act sets forth whistleblower protections discrimination retaliation involving patients employees hospital grievances complaints involvement investigations relating plan


Summary:
Craig Thomas Rural Hospital and Provider Equity Act of 2014 - Expresses the sense of the Senate that residents of rural and frontier communities should have access to affordable, quality health care.

Amends title XVIII (Medicare) of the Social Security Act with respect to:

 the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals; extension of the temporary increase in payments to certain rural hospitals (Medicare hold harmless provision); the Medicare inpatient hospital payment adjustment for low-volume hospitals; Medicare wage index reclassifications for certain hospitals; Medicare reasonable costs payments for certain clinical diagnostic laboratory tests furnished to hospitals in certain rural areas; elimination of the isolation test for the cost-based ambulance reimbursement for critical access hospitals; the capital infrastructure revolving loan program; the Medicare incentive payment program for physician scarcity areas; extension of the 1.00 floor on Medicare work geographic adjustment to payments for physician services; permission for physician assistants to order post-hospital extended care services or hospice care; Medicare home health care planning; rural health clinics; a temporary Medicare payment increase for home health services furnished in a rural area; extension of increased Medicare payments for rural ground ambulance services; and coverage of marriage and family therapist services and mental health counselor services under Medicare part B (Supplementary Medical Insurance). Amends the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 to provide for the extension of the payment for the technical component of certain physician pathology services under Medicare.

Directs the Secretary of Health and Human Services (HHS) to encourage and facilitate the adoption of provisions allowing for multistate practitioner practice across state lines.

Amends title XVIII (Medicare) of the Social Security Act to extend Medicare part A (Hospital Insurance) coverage and payment, on a reasonable cost basis, to anesthesia services furnished by a physician anesthesiologist in certain rural hospitals in the same manner as payment is made for anesthesia services furnished by a certified registered nurse anesthetist (CRNA) in such hospitals.

Establishes the floor at 1.00 on the practice expense geographic index for services furnished during a specified period in certain rural areas outside of frontier states under the Medicare physician fee schedule.

Revises the standard for designation of sole community hospitals.

Amends the Omnibus Budget Reconciliation Act of 1986, as amended by the Omnibus Budget Reconciliation Act of 1989, to include standby and on-call time costs for CRNAs in determination of the reasonable costs incurred by a hospital or critical access hospital for CRNA services.

Amends the Public Health Service Act to extend the authorization of appropriations for grants to states for operation of offices of rural health.

Repeals the Medicare 96-hour physician certification requirement for inpatient critical access hospital services.

Directs the Secretary to continue to apply through 2014 a certain enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals.

thomas rural hospital provider equity act expresses sense senate residents rural frontier communities access affordable quality health_care amends title xviii medicare social_security_act respect medicare disproportionate share hospital dsh adjustment rural hospitals extension temporary increase payments certain rural hospitals medicare hold harmless provision medicare inpatient hospital payment adjustment low volume hospitals medicare wage index reclassifications certain hospitals medicare reasonable costs payments certain clinical diagnostic laboratory tests furnished hospitals certain rural areas elimination isolation test cost based ambulance reimbursement critical access hospitals capital infrastructure revolving loan program medicare incentive payment program physician scarcity areas extension floor medicare work geographic adjustment payments physician services permission physician assistants order post hospital extended care services hospice care medicare_home_health care planning rural health clinics temporary medicare payment increase home health services furnished rural area extension increased medicare payments rural ground ambulance services coverage marriage family therapist services mental health counselor services medicare supplementary_medical_insurance amends medicare medicaid schip benefits improvement protection act provide extension payment technical component certain physician_pathology_services medicare directs secretary health_and_human_services hhs encourage facilitate adoption provisions allowing multistate practitioner practice state lines amends title xviii medicare social_security_act extend medicare hospital insurance coverage payment reasonable cost basis anesthesia services furnished physician anesthesiologist certain rural hospitals manner payment anesthesia services furnished certified registered nurse anesthetist hospitals establishes floor practice expense geographic index services furnished specified period certain rural areas outside frontier states medicare physician fee schedule revises standard designation sole community hospitals amends omnibus_budget_reconciliation_act amended omnibus_budget_reconciliation_act include standby time costs determination reasonable costs incurred hospital critical access hospital services amends public_health_service_act extend authorization appropriations grants states operation offices rural health repeals medicare hour physician certification requirement inpatient critical access hospital services directs secretary continue apply certain enforcement instruction supervision requirements outpatient therapeutic services critical access small rural hospitals


Summary: Transparency in Cost of Veterans Care Act of 2014 - Requires the estimate included in the prospectus accompanying a request to Congress by the President or the Secretary of Veterans Affairs (VA) for funding for a major medical facility project or lease to identify the additional costs of providing hospital care or medical services resulting from the temporary displacement of clinical space required for the project, including the costs of: (1) contracting with a non-VA facility to furnish hospital care or medical services, (2) beneficiary travel, and (3) the lease or purchase of a temporary or mobile medical facility.

transparency cost veterans care act requires estimate included prospectus accompanying request congress president secretary veterans_affairs funding major medical facility project lease identify additional costs providing hospital care medical services resulting temporary displacement clinical space required project including costs contracting non-va facility furnish hospital care medical services beneficiary travel lease purchase temporary mobile medical facility


Summary: Hospital Readmissions Program Accuracy and Accountability Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status.

hospital program accuracy accountability_act amends title xviii medicare social_security_act respect hospital reduction program direct secretary health_and_human_services hhs determining hospital excess ratio purposes making payments discharges starting fy2016 risk adjust account patient socioeconomic status


Summary:
Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to: (1) require post-acute care (PAC) providers to report standardized patient assessment data, data on quality measures, and data on resource use and other measures; (2) require the data to be interoperable to allow for its exchange among PAC and other providers to give them access to longitudinal information so as to facilitate coordinated care and improve Medicare beneficiary outcomes; and (3) modify PAC assessment instruments applicable to PAC providers for the submission of standardized patient assessment data on such providers and enable assessment data comparison across all such providers.

Directs the Secretary to: (1) provide confidential feedback reports to PAC providers on their performance with respect to required measures; and (2) arrange for public reporting of PAC provider performance on quality, resource use, and other measures.

Directs the Medicare Payment Advisory Commission (MEDPAC) to: (1) evaluate and recommend to Congress features of PAC payment systems that establish, or a unified PAC payment system that establishes, payment rates according to characteristics of individuals instead of according to the PAC setting where the Medicare beneficiary involved is treated; and (2) recommend to Congress a technical prototype for a PAC prospective payment system.

Directs the Secretary to reduce by 2% the update to the market basket percentage for skilled nursing facilities which do not report assessment and quality data.

Directs the Secretary to study: (1) the effect of individuals' socioeconomic status on quality, resource use, and other measures for individuals under the Medicare program; and (2) the impact on such measures of specified risk factors.

improving medicare post acute care transformation act impact act amends title xviii medicare social_security_act direct secretary health_and_human_services hhs require post acute care pac providers report standardized patient assessment data data quality measures data resource use measures require data interoperable allow exchange pac providers access longitudinal information facilitate coordinated care improve medicare beneficiary outcomes modify pac assessment instruments applicable pac providers submission standardized patient assessment data providers enable assessment data comparison providers directs secretary provide confidential feedback reports pac providers performance respect required measures arrange public reporting pac provider performance quality resource use measures directs medicare_payment_advisory_commission medpac evaluate recommend congress features pac payment systems establish unified pac payment system establishes payment rates according characteristics individuals instead according pac setting medicare beneficiary involved treated recommend congress technical prototype pac prospective payment system directs secretary reduce update market basket percentage skilled nursing facilities report assessment quality data directs secretary study effect individuals socioeconomic status quality resource use measures individuals medicare program impact measures specified risk factors


Summary:
Value Based Insurance Design for Better Care Act of 2014 or the VBID for Better Care Act of 2014 - Directs the Secretary of Health and Human Services (HHS) to establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare plans offered by Medicare Advantage organizations under part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act.

Defines "value-based insurance design methodology" as one for identifying specific prescription medications, and clinical services reimbursable under Medicare, for which copayments, coinsurance, or both should be reduced or eliminated because of the high-value and effectiveness of these medications and services for specific chronic clinical conditions (as approved by the Secretary).

Directs the Secretary to expand the demonstration program to implement, on a permanent basis, those components beneficial to Medicare beneficiaries and the Medicare program, unless a required evaluation of the program states that it: (1) increases expenditures under Medicare with respect to participating beneficiaries, or (2) decreases the quality of health care services furnished to such beneficiaries.

value based insurance design better care act better care act directs secretary health_and_human_services hhs establish year demonstration program test use value based insurance design methodologies eligible medicare plans offered medicare_advantage organizations title xviii medicare social_security_act defines value based insurance design methodology identifying specific prescription medications clinical services reimbursable medicare copayments coinsurance reduced eliminated high value effectiveness medications services specific chronic clinical conditions approved secretary directs secretary expand demonstration program implement permanent basis components beneficial medicare beneficiaries medicare program required evaluation program states increases expenditures medicare respect participating beneficiaries decreases quality health_care services furnished beneficiaries


Summary: Ensuring Equal Access to Treatments Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act, with respect to the prospective payment system for hospital outpatient department (OPD) services, to direct the Secretary of Health and Human Services (HHS) to create certain additional groups of covered OPD services that classify separately, from those that do not utilize such a drug, procedures that utilize a drug (other than contrast agents and diagnostic radiopharmaceuticals) that both has a cost above the drug packaging threshold and functions as a supply when used in a diagnostic test or procedure.

ensuring equal_access treatments act amends title xviii medicare social_security_act respect prospective payment system hospital outpatient department opd services direct secretary health_and_human_services hhs create certain additional groups covered opd services classify separately utilize drug procedures utilize drug agents diagnostic cost drug packaging threshold functions supply diagnostic test procedure


Summary:
Critical Access Hospital Relief Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital.

critical access hospital relief_act amends title xviii medicare social_security_act repeal hour physician certification requirement inpatient critical access hospital services physician certify patient reasonably expected discharged transferred hospital hours admission critical access hospital


Summary:
Rural Health Care Provider Relief Act of 2015

Directs the Secretary of Health and Human Services, during a specified extension period, to extend the therapy supervision nonenforcement instruction (the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals, as extended for calendar year 2013 by the Centers for Medicare & Medicaid Services and through calendar year 2014 by Public Law 113-198).

Directs the Secretary to study the impact (including the economic impact and the impact upon hospital staffing needs, if any) on critical access hospitals and small rural hospitals of not extending the therapy supervision nonenforcement instruction.

rural health_care provider relief_act directs secretary health_and_human_services specified extension period extend therapy supervision instruction enforcement instruction supervision requirements outpatient therapeutic services critical access small rural hospitals extended calendar year centers medicare medicaid_services calendar year public law directs secretary study impact including economic impact impact hospital staffing needs critical access hospitals small rural hospitals extending therapy supervision instruction


Summary:
Aurora VA Hospital Financing and Construction Reform Act of 2015

Authorizes the Secretary of Veterans Affairs (VA) to carry out the Aurora medical facility project to replace the VA Medical Center in Denver, Colorado.

Requires VA to enter into an agreement with the Army Corps of Engineers giving the Corps the authority to perform the project, design, contract, and construction management necessary to complete such project.

aurora hospital financing construction reform_act authorizes secretary veterans_affairs carry aurora medical facility project replace medical center denver colorado requires_va enter agreement army_corps_of_engineers giving corps authority perform project design contract construction management necessary complete project


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

Access to Life-Saving Trauma Care for All Americans Act

(Sec. 2) This bill amends the Public Health Service Act to reauthorize grants for certain trauma centers and grants to states for trauma centers through FY2020. The categorization of certain trauma centers is revised.

(Sec. 3) The Assistant Secretary for Preparedness and Response is given the authority to administer these grants.

measure amended introduced summary expanded action occurred measure access life saving trauma care americans act sec bill amends public_health_service_act reauthorize grants certain trauma centers grants states trauma centers fy2020 categorization certain trauma centers revised sec assistant secretary preparedness response given authority administer grants


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

Trauma Systems and Regionalization of Emergency Care Reauthorization Act

(Sec. 2) This bill amends the Public Health Service Act to reauthorize trauma care programs through FY2020.

(Sec. 3) Grants for pilot projects of innovative models of emergency care and trauma systems can be allocated up to half of the remaining funds for trauma care after allocations for improvement of emergency medical services in rural areas and administrative purposes.

State plans for emergency medical services are required to include the national standards and requirements of the American Burn Association for verified burn centers.

The Department of Health and Human Services must update the model plan for designation of trauma centers and for triage, transfer, and transportation policies, taking into account standards from the American Burn Association.

measure amended introduced summary expanded action occurred measure trauma systems emergency care reauthorization act sec bill amends public_health_service_act reauthorize trauma care programs fy2020 sec grants pilot projects innovative models emergency care trauma systems allocated half remaining funds trauma care allocations improvement emergency medical services rural areas administrative purposes state plans emergency medical services required include national standards requirements american burn association verified burn centers department_of_health_and_human_services update model plan designation trauma centers transfer transportation policies taking account standards american burn association


Summary:
Rural Hospital Access Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to make permanent the Medicare-dependent, small rural subsection (d) hospital program and increased payments under the Medicare low-volume hospital program.

 (Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

rural hospital access act bill amends title xviii medicare social_security_act permanent medicare dependent small rural subsection hospital program increased payments medicare low volume hospital program generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system ipps providing covered inpatient services eligible beneficiaries


Summary:
Rural Community Hospital Demonstration Extension Act of 2015

Amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, as amended by the Patient Protection and Affordable Care Act, to extend the period of the rural community hospital demonstration program from 5 to 10 years.

rural community hospital demonstration extension act amends medicare_prescription_drug improvement modernization act amended patient_protection affordable care act extend period rural community hospital demonstration program years


Summary:
Directs the Secretary of Veterans Affairs to carry out a two-year pilot program under which: (1) eligible veterans may elect to receive hospital care and services at non-Department of Veterans Affairs (VA) facilities, and (2) the Secretary shall reimburse such facilities for the cost of such care and services.

Defines an "eligible veteran" as a veteran who: (1) is enrolled in the VA's patient enrollment system, and (2) resides in a geographic area selected by the Secretary. Directs the Secretary to select: (1) one geographic area within each Veterans Integrated Service Network, and (2) NJ-2 as the geographic area for participation in the pilot program for Veterans Integrated Service Network 4.

Requires the Secretary to: (1) issue a unique identification card to each eligible veteran who elects to receive hospital care and medical services at non-VA facilities under the pilot program, and (2) take steps to ensure that such veterans receive such care and services at such non-VA facilities.

directs secretary veterans_affairs carry year pilot program eligible veterans elect receive hospital care services non-department_of_veterans_affairs facilities secretary shall reimburse facilities cost care services defines eligible veteran veteran enrolled patient enrollment system resides geographic area selected secretary directs secretary select geographic area veterans_integrated_service_network geographic area participation pilot program veterans_integrated_service_network requires secretary issue unique identification card eligible veteran elects receive hospital care medical services non-va facilities pilot program steps ensure veterans receive care services non-va facilities


Summary:
Stark Administrative Simplification Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to prescribe a single civil monetary penalty as an alternative sanction to those already established for compensation arrangements between a physician (or an immediate family member) and a person or entity that is in violation of the limitation on certain physician referrals (Stark Law) solely due to technical noncompliance.

(The Stark law, or Stark Rule, prohibits physician referrals of certain health services for Medicare and Medicaid patients to a specified entity if the physician, or an immediate family member, has a financial relationship with that entity.)

Requires the Secretary of Health and Human Services to accept the voluntary disclosure of a technically noncomplaint compensation arrangement by a person or entity in violation of the Stark Law under certain circumstances.

administrative simplification act amends title xviii medicare social_security_act prescribe single civil monetary penalty alternative sanction established compensation arrangements physician immediate family member person entity violation limitation certain physician referrals law solely technical noncompliance law rule prohibits physician referrals certain health services medicare medicaid patients specified entity physician immediate family member financial relationship entity requires secretary health_and_human_services accept voluntary disclosure technically compensation arrangement person entity violation law certain circumstances


Summary:
Medicare Payment Rate Disclosure Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to make publicly available on the official Medicare Internet site during a specified initial period: (1) Medicare payment rates for frequently reimbursed hospital inpatient and outpatient procedures and services, as well as for physicians' services; and (2) the period for which payment rates are applicable. Requires posting also after the initial period of an expanded selection of such items.

Directs the Secretary to select at least 30 procedures and services for the basic posting and at least 100 procedures and services for the expanded posting.

medicare payment rate disclosure act amends title xviii medicare social_security_act direct secretary health_and_human_services publicly available official medicare internet site specified initial period medicare payment rates frequently reimbursed hospital inpatient outpatient procedures services physicians services period payment rates applicable requires posting initial period expanded selection items directs secretary select procedures services basic posting procedures services expanded posting


Summary:
(This measure has not been amended since it was passed by the House on March 16, 2015. The summary of that version is repeated here.) Notice of Observation Treatment and Implication for Care Eligibility Act or the NOTICE Act

(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning to receive them which:

 explains the individual's status as an outpatient and not as an inpatient and the reasons why; explains the implications of that status on services furnished (including those furnished as an inpatient), in particular the implications for cost-sharing requirements and subsequent coverage eligibility for services furnished by a skilled nursing facility; includes appropriate additional information; is written and formatted using plain language and made available in appropriate languages; and is signed by the individual or a person acting on the individual's behalf (representative) to acknowledge receipt of the notification, or if the individual or representative refuses to sign, the written notification is signed by the hospital staff who presented it.

measure amended passed house march summary version repeated notice observation treatment care eligibility act notice act sec bill amends title xviii medicare social_security_act require hospital critical access hospital agreement secretary health_and_human_services individual receives observation services outpatient hours adequate oral written notification hours beginning receive explains individual status outpatient inpatient reasons explains implications status services furnished including furnished inpatient particular implications cost sharing requirements subsequent coverage eligibility services furnished skilled nursing facility includes appropriate additional information written plain language available appropriate languages signed individual person acting individual behalf representative acknowledge receipt notification individual representative refuses sign written notification signed hospital staff presented


Summary:
Electronic Health Fairness Act of 2015

(Sec. 2) Amends title XVIII (Medicare) of the Social Security Act to prohibit for a payment year after 2015 any patient encounter of an eligible professional occurring at an ambulatory surgical center (ASC) from being treated as such a patient encounter in determining whether an eligible professional qualifies as a meaningful electronic health record (EHR) user.

Terminates this prohibition three years after the Secretary of Health and Human Services determines, through notice and comment rulemaking, that certified EHR technology is applicable to the ASC setting.

electronic health fairness act sec amends title xviii medicare social_security_act prohibit payment year patient encounter eligible professional occurring ambulatory surgical center treated patient encounter determining eligible professional qualifies meaningful electronic health record ehr user terminates prohibition years secretary health_and_human_services determines notice comment rulemaking certified ehr technology applicable setting


Summary:
Ensuring Equal Access to Treatments Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act, with respect to the prospective payment system for hospital outpatient department (OPD) services, to direct the Secretary of Health and Human Services to create certain additional groups of covered OPD services that classify separately, from those that do not utilize such a drug, procedures that utilize a drug (other than contrast agents, diagnostic radiopharmaceutical, or anesthesia drugs) that both has a cost above the drug packaging threshold and functions as a supply when used in a diagnostic test or procedure.

ensuring equal_access treatments act amends title xviii medicare social_security_act respect prospective payment system hospital outpatient department opd services direct secretary health_and_human_services create certain additional groups covered opd services classify separately utilize drug procedures utilize drug agents diagnostic anesthesia drugs cost drug packaging threshold functions supply diagnostic test procedure


Summary:
Meeting the Inpatient Health Care Needs of Far South Texas Veterans Act of 2015

Directs the Secretary of Veterans Affairs (VA): (1) to ensure that the South Texas Veterans Affairs Health Care Center in Harlingen, Texas, includes a full-service VA inpatient health care facility; and (2) if needed, to modify the existing facility to meet this requirement.

meeting inpatient health_care needs far south texas veterans act directs secretary veterans_affairs ensure south texas veterans_affairs health_care center texas includes service inpatient health_care facility needed modify existing facility meet requirement


Summary:
Ask Veterans Act

Directs the Secretary of Veterans Affairs (VA) to contract with an experienced non-government entity to conduct an annual survey, over a five-year period, to determine the experiences of veterans in obtaining hospital care and medical services at each VA medical facility.

Requires those surveys to include questions relating to:

 a veteran's ability to obtain hospital care and medical services at the facility in a timely manner, the time between the date the veteran requests an appointment and the date the appointment is scheduled, the frequency with which scheduled appointments are cancelled, and the quality of hospital care or medical services received. Directs the Secretary to make the results of the surveys publicly available on the VA's Internet website.

ask veterans act directs secretary veterans_affairs contract experienced non government entity conduct annual survey year period determine experiences veterans obtaining hospital care medical services medical facility requires surveys include questions relating veteran ability obtain hospital care medical services facility timely manner time date veteran requests appointment date appointment scheduled frequency scheduled appointments cancelled quality hospital care medical services received directs secretary results surveys publicly available internet website


Summary:
Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act (SSAct) with respect to the hospital readmissions reduction program under the inpatient (hospital) prospective payment system (IPPS).

The Secretary of Health and Human Services, in determining a hospital's excess readmission ratio for purposes of making payments for discharges occurring during FY2016-FY2017, is required to make a risk adjustment to the ratio that takes into account both: (1) a hospital's proportion of inpatients who are full-benefit dual eligible individuals (eligible for both Medicare and Medicaid under SSAct title XIX), and (2) the socioeconomic status of patients served by the hospital.

The Secretary must base the risk adjustment under the readmission program for subsequent fiscal years on specified reports required by the Improving Medicare Post Acute Care Transformation Act of 2014 as well as a report the Medicare Payment Advisory Commission shall submit on the appropriateness of using a threshold of 30 days for readmissions under the program. The Administrator of the Centers for Medicare & Medicaid Services must then incorporate report recommendations in carrying out risk adjustments for discharges occurring in such fiscal years in order to ensure that the most vulnerable populations are not unfairly penalized by the program.

The Secretary shall consider the use of V or other International Classification of Diseases-related codes for potential exclusion of noncompliant patient cases when promulgating related regulations for FY2017.

The Secretary must: (1) assess whether to exclude from the calculation of excess readmissions any patients whose clinical conditions or diagnoses may require frequent hospitalizations; then (2) exclude, starting in FY2018, any relevant clinical conditions identified in the assessment recommendations when determining a hospital's publicly reported readmission rate and excess readmissions ratio.

The Secretary is directed to make a payment adjustment to subsection (d) hospitals necessary to ensure that the implementation of this Act does not result in any increase in aggregate expenditures under the IPPS.

(Generally, a subsection (d) hospital is an acute care hospital, particularly one that receives payment under the IPPS when providing covered inpatient services to eligible beneficiaries.)

establishing beneficiary equity hospital program act bill amends title xviii medicare social_security_act ssact respect hospital reduction program inpatient hospital prospective payment system ipps secretary health_and_human_services determining hospital excess ratio purposes making payments discharges occurring fy2016 fy2017 required risk adjustment ratio takes account hospital proportion benefit dual eligible individuals eligible medicare medicaid ssact title xix socioeconomic status patients served hospital secretary base risk adjustment program subsequent fiscal years specified reports required improving medicare post acute care transformation act report medicare_payment_advisory_commission shall submit appropriateness threshold days program administrator centers medicare medicaid_services incorporate report recommendations carrying risk adjustments discharges occurring fiscal years order ensure vulnerable populations unfairly penalized program secretary shall consider use international classification diseases related codes potential exclusion noncompliant patient cases promulgating related regulations fy2017 secretary assess exclude calculation excess patients clinical conditions diagnoses require frequent hospitalizations exclude starting fy2018 relevant clinical conditions identified assessment recommendations determining hospital publicly reported rate excess ratio secretary directed payment adjustment subsection hospitals necessary ensure implementation act result increase aggregate expenditures ipps generally subsection hospital acute care hospital particularly receives payment ipps providing covered inpatient services eligible beneficiaries


Summary:
Ambulatory Surgical Center Quality and Access Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to require alignment of updates for ambulatory surgical center (ASC) services under a revised prospective payment system (PPS) with updates for hospital outpatient department (OPD) services.

Revises requirements for the reporting and applying of quality measure data by ASCs and hospital OPDs.

Revises requirements for the composition of the expert outside advisory panel the Secretary of Health and Human Services is required to consult during the annual review of the clinical integrity of the groups and payment weights in the PPS for OPD services. Requires the panel to include suppliers subject to the PPS as well as at least one ASC representative.

Requires the Secretary, when excluding from a final rule updating ASC lists a procedure whose inclusion was requested during the public comment period, to cite in the final rule specific criteria based on which the procedure was excluded. Requires the Secretary also to identify the peer reviewed research or the evidence upon which the exclusion is based if certain of those criteria are cited for it. Prohibits the Secretary from using or citing as a criterion or a basis for an exclusion that the procedure can only be reported using a Current Procedural Terminology unlisted surgical procedure code.

ambulatory surgical center quality access act amends title xviii medicare social_security_act require alignment updates ambulatory surgical center services revised prospective payment system pps updates hospital outpatient department opd services revises requirements reporting applying quality measure data hospital revises requirements composition expert outside advisory_panel secretary health_and_human_services required consult annual review clinical integrity groups payment weights pps opd services requires panel include suppliers subject pps representative requires secretary excluding final rule updating lists procedure inclusion requested public comment period cite final rule specific criteria based procedure excluded requires secretary identify peer reviewed research evidence exclusion based certain criteria cited prohibits secretary criterion basis exclusion procedure reported current procedural terminology surgical procedure code


Summary:
Bundling and Coordinating Post-Acute Care Act of 2015 or the BACPAC Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to require a single bundled payment for post-acute care services under Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance).

Defines "PAC physician" as the physician with primary responsibility for supervising delivery to an individual of a post-acute care (PAC) bundle of services between a qualifying discharge and the earlier of: (1) 90 days later, or (2) the date on which the individual is admitted to a hospital to receive services for a condition unrelated to the one for which he or she received the acute care inpatient hospital services.

Directs the Secretary of Health and Human Services to study the feasibility of integrating ("bundling") all payments under the Medicare program for post acute care services with payments for acute care inpatient hospital services in a subsection (d) hospital. (Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

Places a moratorium on the IPPS payment rate in certain cases.

Directs the Secretary to: (1) establish a new Transitional Care Management (TCM) code, with respect to geographic adjustments to the physicians' fee schedule, to pay for care management by a PAC physician; or (2) revise and expand the use of existing TCM codes 99495 and 99494.

bundling coordinating post acute care act act amends title xviii medicare social_security_act require single bundled payment post acute care services medicare parts hospital insurance supplementary_medical_insurance defines pac physician physician primary responsibility supervising delivery individual post acute care pac bundle services qualifying discharge earlier days later date individual admitted hospital receive services condition unrelated received acute care inpatient hospital services directs secretary health_and_human_services study feasibility integrating bundling payments medicare program post acute care services payments acute care inpatient hospital services subsection hospital generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system ipps providing covered inpatient services eligible beneficiaries places moratorium ipps payment rate certain cases directs secretary establish new transitional care management code respect geographic adjustments physicians fee schedule pay care management pac physician revise expand use existing codes


Summary:
Repeal of the Obamacare Bay State Boondoogle Act

Revises requirements for the non-rural area wage index floor in the formula for the national adjusted diagnosis-related group (DRG) prospective payment rate used in calculating payments under title XVIII (Medicare) of the Social Security Act for each inpatient hospital discharge in a fiscal year involving inpatient hospital services of a subsection (d) hospital. (Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

Directs the Secretary of Health and Human Services, in the case of discharges occurring on or after April 1, 2015, to apply budget neutrality, under the Balanced Budget Act of 1997 and related regulations, on a state-specific rather than national basis in the calculation of the Medicare hospital wage index floor, including a minimum wage index, for each non-rural area, using a specified methodology as if it had been fully implemented for FY2011 using a 100% state-specific adjustment to the area wage index.

Declares that nothing in this Act shall be construed as preventing the Secretary, for discharges occurring on or after April 1, 2015, from modifying related regulations in carrying out budget neutrality requirements.

Amends the Patient Protection and Affordable Care Act to end the application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor as of April 1, 2015.

repeal obamacare bay state act revises requirements non rural area wage index floor formula national adjusted diagnosis related group prospective payment rate calculating payments title xviii medicare social_security_act inpatient hospital discharge fiscal year involving inpatient hospital services subsection hospital generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system ipps providing covered inpatient services eligible beneficiaries directs secretary health_and_human_services case discharges occurring april apply budget neutrality balanced_budget act related regulations state specific national basis calculation medicare hospital wage index floor including minimum wage index non rural area specified methodology fully implemented fy2011 state specific adjustment area wage index declares act shall construed preventing secretary discharges occurring april modifying related regulations carrying budget neutrality requirements amends patient_protection affordable care act end application budget neutrality national basis calculation medicare hospital wage index floor april


Summary:
Medicare Audit Improvement Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to require that any records or documentation of an orthotist or prosthetist who furnished an orthotic, prosthetic, or prosthetic device to an individual shall be considered part of the individual's medical record in determining whether the item is reasonable and necessary.

Medicare administrative contractors (MACs) shall determine that payment may not be made to a supplier of durable medical equipment (DME) or of orthotics and prosthetics for which a claim is made because the supplier does not meet requirements for licensing or accreditation by a National Board.

Recovery audit contractors (RACs) shall consider an overpayment that must be recouped any payment for DME, orthotics, or prosthetics that should not have been made because the supplier failed to meet licensing or accreditation criteria.

RACs are prohibited from reviewing payments for certain DME, orthotics, or prosthetics to which prior Medicare authorization applies.

The Secretary of Health and Human Services must report annually to Congress certain information on determinations by MACs that payment cannot be made, and by RACs that payment should not have been made, under Medicare for items and services.

Payment is prohibited under part B (Supplementary Medical Insurance) of Medicare for orthotics and prosthetics furnished by a supplier without a supplier number. To obtain such a number a supplier must meet specified criteria.

The Secretary must: (1) review annually the coverage and utilization of orthotics and prosthetics to determine whether they should be subjected to coverage and utilization review criteria, and if appropriate (2) develop and apply such criteria.

Patients are not liable for payment of furnished orthotics and prosthetics which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Competitive acquisition programs shall not apply to off-the-shelf items and services furnished by certain orthotists or prosthetists who are either licensed or, in a state without licensing requirements, meet specified training, education, certification, or credentialing criteria.

Recoupment of payments to a qualifying provider or supplier may not be made before completion of an administrative law judge appeals process.

Payment under Medicare is denied to suppliers and providers unless they meet certain licensing or other qualifications.

medicare audit improvement act bill amends title xviii medicare social_security_act require records documentation furnished orthotic prosthetic prosthetic device individual shall considered individual medical record determining item reasonable necessary medicare administrative contractors macs shall determine payment supplier durable medical equipment dme orthotics prosthetics claim supplier meet requirements licensing accreditation national board recovery audit contractors shall consider overpayment payment dme orthotics prosthetics supplier failed meet licensing accreditation criteria prohibited reviewing payments certain dme orthotics prosthetics prior medicare authorization applies secretary health_and_human_services report annually congress certain information determinations macs payment payment medicare items services payment prohibited supplementary_medical_insurance medicare orthotics prosthetics furnished supplier supplier number obtain number supplier meet specified criteria secretary review annually coverage utilization orthotics prosthetics determine subjected coverage utilization review criteria appropriate develop apply criteria patients liable payment furnished orthotics prosthetics reasonable necessary diagnosis treatment illness injury improve functioning body member competitive acquisition programs shall apply shelf items services furnished certain licensed state licensing requirements meet specified training education certification credentialing criteria recoupment payments qualifying provider supplier completion administrative law judge appeals process payment medicare denied suppliers providers meet certain licensing qualifications


Summary:
Improving Access to Medicare Coverage Act of 2015

Amends title XVIII (Medicare) of the Social Security Act to deem an individual receiving outpatient observation services in a hospital to be an inpatient with respect to satisfying the three-day inpatient hospital requirement in order to entitle the individual to Medicare coverage of any post-hospital extended care services in a skilled nursing facility.

improving access medicare coverage act amends title xviii medicare social_security_act deem individual receiving outpatient observation services hospital inpatient respect satisfying day inpatient hospital requirement order entitle individual medicare coverage post hospital extended care services skilled nursing facility


Summary:
Nurse Staffing Standards for Patient Safety and Quality Care Act of 2015

Amends the Public Health Service Act to require hospitals to implement and submit to the Department of Health and Human Services (HHS) a staffing plan that complies with specified minimum nurse-to-patient ratios by unit. Requires HHS to develop a transparent method for establishing nurse staffing requirements above minimum ratios.

Directs HHS to adjust Medicare payments to hospitals to cover additional costs incurred in providing services to Medicare beneficiaries that are attributable to compliance with such ratios.

Allows a nurse to object to, or refuse to participate in, any assignment if it would violate minimum ratios or if the nurse is not prepared by education or experience to fulfill the assignment without compromising the safety of a patient or jeopardizing the nurse's license. Prohibits a hospital from: (1) taking specified actions against a nurse based on the nurse's refusal to accept an assignment for such a reason; or (2) discriminating against any individual for good faith complaints relating to the care, services, or conditions of the hospital or of any related facilities.

Adds stipends to the nurse workforce loan repayment and scholarship program. Expands the nurse retention grant program to authorize programs to implement nurse preceptorship and mentorship projects.

nurse staffing standards patient safety quality care act amends public_health_service_act require hospitals implement submit department_of_health_and_human_services hhs staffing plan complies specified minimum nurse patient ratios unit requires hhs develop transparent method establishing nurse staffing requirements minimum ratios directs hhs adjust medicare payments hospitals cover additional costs incurred providing services medicare beneficiaries attributable compliance ratios allows nurse object refuse participate assignment violate minimum ratios nurse prepared education experience fulfill assignment compromising safety patient jeopardizing nurse license prohibits hospital taking specified actions nurse based nurse refusal accept assignment reason discriminating individual good faith complaints relating care services conditions hospital related facilities adds stipends nurse workforce loan repayment scholarship program expands nurse retention grant program authorize programs implement nurse mentorship projects


Summary:
Lymphedema Treatment Act

This bill amends title XVIII (Medicare) of the Social Security Act to cover certain lymphedema compression treatment items as durable medical equipment under Medicare. (Lymphedema is a condition of localized fluid retention and tissue swelling that is caused when the lymphatic system is damaged or blocked.)

treatment act bill amends title xviii medicare social_security_act cover certain compression treatment items durable medical equipment medicare condition fluid retention tissue caused system damaged blocked


Summary:
Physician Availability Act of 2015

Requires each covered hospital to have a qualified physician available in the hospital at all times to attend to the needs of the hospital's inpatients. Defines a "covered hospital" to: (1) include hospitals participating in Medicare or Medicaid or receiving federal funds, and (2) exclude hospitals in a federal facility or hospitals that the Department of Health and Human Services determines have fewer than 100 licensed beds.

 Considers a physician to be available if: (1) the physician is physically present in the hospital; (2) the physician's primary responsibility is to be in attendance to serve the needs of the hospital's inpatients without delay; and (3) the physician is not physically present in, assigned to, serving in, or expected to cover the hospital's emergency room or emergency department.

Sets forth penalties for violations.

physician availability act requires covered hospital qualified physician available hospital times attend needs hospital defines covered hospital include hospitals participating medicare medicaid receiving federal funds exclude hospitals federal facility hospitals department_of_health_and_human_services determines fewer licensed beds considers physician available physician physically present hospital physician primary responsibility attendance serve needs hospital delay physician physically present assigned serving expected cover hospital emergency room emergency department sets forth penalties violations


Summary:
VA Construction, Accountability, and Reform Act

This bill authorizes the Secretary of Veterans Affairs (VA) to carry out the major medical facility project to replace the VA Medical Center in Denver, Colorado (Aurora Project).

 The Secretary may not pay any bonus during FY2015-FY2016. If the Aurora Project is not completed by September 30, 2016, the Secretary may not pay any bonus until the date on which the Secretary certifies to Congress that such Project is fully operational. The aggregate amount of subsequent fiscal year bonuses is capped through FY2024.

 The Secretary shall enter into an agreement with the Secretary of the Army for the Army Corps of Engineers to carry out the design, contract, construction management, and other similar services for the Aurora Project.

The bill prohibits the VA Secretary from carrying out a major medical facility project and requires the Secretary of the Army, acting through the Chief of Engineers, to carry out all major medical facility projects for the VA.

 The Government Accountability Office shall review the Secretary's management of the Aurora Project.

 The Secretary must notify Congress at least 120 days (currently, at least 30 days) before obligating funds for major medical facility projects that exceed authorized amounts.

construction accountability reform_act bill authorizes secretary veterans_affairs carry major medical facility project replace medical center denver colorado aurora project secretary pay bonus fy2015 fy2016 aurora project completed september secretary pay bonus date secretary certifies congress project fully operational aggregate subsequent fiscal year bonuses capped fy2024 secretary shall enter agreement secretary army army_corps_of_engineers carry design contract construction management similar services aurora project bill prohibits secretary carrying major medical facility project requires secretary army acting chief_of_engineers carry major medical facility projects government_accountability_office shall review secretary management aurora project secretary notify congress days currently days obligating funds major medical facility projects exceed authorized amounts


Summary:
Construction Reform, Authorization, and Choice Improvement Act of 2015

This bill requires the Department of Veterans Affairs (VA) to: (1) enter into an agreement with an appropriate non-VA entity to provide full project management services for a super construction project; and (2) use industry standards, standard designs, and best practices in carrying out medical facility construction.

A super construction project is one for the construction, alteration, or acquisition of a medical facility involving a total expenditure of more than $100 million (but does not include an acquisition by exchange).

The VA is prohibited from:

 obligating or expending funds for advance planning or design for any super construction project until 60 days after congressional notification, obligating funds for a major medical facility project or a super construction project by more than 10% of the amount approved by law unless certain congressional committees each approve the obligation, and using bid savings amounts or funds for other than their original purpose before 30 days after notifying such committees unless each committee approves the obligation. The VA must complete a master plan for each VA medical facility meeting specified requirements to inform investment decisions and funding requests over a 10-year period for construction projects at the facility.

The 40-mile distance requirement for a veteran to use a non-VA medical facility under the veterans choice program of the Veterans Access, Choice, and Accountability Act of 2014 means 40 miles calculated on the basis of distance traveled.

The VA may carry out the following major medical facility projects in FY2015 (with each project not to exceed specified amounts):

 construction of a community living center, outpatient clinic, renovated domiciliary, and renovation of existing buildings in Canandaigua, New York; seismic corrections to the mental health and community living center in Long Beach, California; seismic correction of 12 buildings in West Los Angeles, California; and construction of a spinal cord injury building and seismic corrections in San Diego, California. VA authority to make medical services and hospital care available for eligible veterans through agreements with non-VA entities shall now be permanent.

The sense of Congress regarding the Veterans Choice Fund is revised.

construction reform authorization choice improvement act bill requires department_of_veterans_affairs enter agreement appropriate non-va entity provide project management services super construction project use industry standards standard designs best practices carrying medical facility construction super construction project construction alteration acquisition medical facility involving total expenditure million include acquisition exchange prohibited obligating expending funds advance planning design super construction project days congressional notification obligating funds major medical facility project super construction project approved law certain congressional committees approve obligation bid savings amounts funds original purpose days notifying committees committee approves obligation complete master plan medical facility meeting specified requirements inform investment decisions funding requests year period construction projects facility mile distance requirement veteran use non-va medical facility veterans_choice_program veterans access choice accountability_act means miles calculated basis distance traveled carry following major medical facility projects fy2015 project exceed specified amounts construction community living center outpatient clinic domiciliary renovation existing buildings new_york seismic corrections mental health community living center long_beach california seismic correction buildings west los_angeles california construction spinal cord injury building seismic corrections san_diego california authority medical services hospital care available eligible veterans agreements non-va entities shall permanent sense congress veterans choice fund revised


Summary: Amends title XIX (Medicaid) of the Social Security Act to require states to have in place a system for the electronic verification of visits conducted as part of personal care services or else have their federal medical assistance percentage reduced by specified amounts.

amends title xix medicaid social_security_act require states place system electronic verification visits conducted personal care services federal medical assistance percentage reduced specified amounts


Summary:
(This measure has not been amended since it was introduced. The expanded summary of the House passed version is repeated here.)

Construction Authorization and Choice Improvement Act

(Sec. 2) This bill authorizes the Secretary of Veterans Affairs (VA) to carry out the replacement of the existing VA Medical Center in Denver, Colorado, in FY2015 in an amount not to exceed $900 million.

(Sec. 3) The 40-mile distance requirement for a veteran to use a non-VA medical facility under the veterans choice program of the Veterans Access, Choice, and Accountability Act of 2014 shall be construed to allow a veteran to access a non-VA medical facility if:

 the veteran resides more than 40 miles driving distance from the closest VA facility; or the veteran faces an unusual or excessive burden in traveling to such VA medical facility not only because of geographical challenges (as under current law) but also because of environmental factors, such as roads that are not accessible to the general public, traffic, or hazardous weather, because of a medical condition that impacts the ability to travel, or because of other factors as the Secretary determines.

measure amended introduced expanded summary house passed version repeated construction authorization choice improvement act sec bill authorizes secretary veterans_affairs carry replacement existing medical center denver colorado fy2015 exceed million sec mile distance requirement veteran use non-va medical facility veterans_choice_program veterans access choice accountability_act shall construed allow veteran access non-va medical facility veteran resides miles driving distance closest facility veteran faces unusual excessive burden traveling medical facility geographical challenges current law environmental factors roads accessible general public traffic hazardous weather medical condition impacts ability travel factors secretary determines


Summary:
Comprehensive Care Payment Innovation Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to provide for bundled payments for integrated care furnished by a qualified entity, during an episode of care for applicable conditions involving a hospitalization, to an individual entitled to, or enrolled for, benefits under Medicare part A (Hospital Insurance) and enrolled for benefits under Medicare part B (Supplementary Medical Insurance), but not enrolled under Medicare part C (Medicare+Choice Program) or in a PACE (Programs of All-Inclusive Care for the Elderly) program.

comprehensive care payment innovation_act amends title xviii medicare social_security_act direct secretary health_and_human_services provide bundled payments integrated care furnished qualified entity episode care applicable conditions involving hospitalization individual entitled enrolled benefits medicare hospital insurance enrolled benefits medicare supplementary_medical_insurance enrolled medicare program pace programs inclusive care elderly program


Summary:
Promoting Access, Competition, and Equity Act of 2015 or the PACE Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to ease application criteria and procedures for physician-owned hospitals to expand their facilities. Under current law, expansion of physician-owned hospitals is subject to certain limitations, such as those regarding the extent and frequency of expansion and requiring community output. The bill suspends these limitations with respect to applications for expansion filed before October 1, 2019.

Following the end of this suspension period, hospitals with consistently high quality ratings are included among those hospitals that may apply to expand their facilities. The Centers for Medicare & Medicaid Services may not alter the methodology for computing a hospital's quality rating before October 1, 2019.

With respect to hospitals under development as of March 23, 2010, the bill extends to May 1, 2015, the date by which a hospital may qualify for an exception to the ownership or investment prohibition on physician self-referrals.

The bill also: (1) exempts physician-owned hospitals from specified documentation and coding adjustments, and (2) extends reductions in certain inflationary increases associated with Medicare payments for inpatient hospital services.

promoting access competition equity act pace act bill amends title xviii medicare social_security_act ease application criteria procedures physician owned hospitals expand facilities current law expansion physician owned hospitals subject certain limitations extent frequency expansion requiring community output bill suspends limitations respect applications expansion filed october following end suspension period hospitals consistently high quality ratings included hospitals apply expand facilities centers medicare medicaid services alter methodology computing hospital quality rating october respect hospitals development march bill extends date hospital qualify exception ownership investment prohibition physician self referrals bill exempts physician owned hospitals specified documentation coding adjustments extends reductions certain increases associated medicare payments inpatient hospital services


Summary:
Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015

(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act (SSAct) with respect to criteria for qualifying as a meaningful user of electronic health records (meaningful EHR user). For any payment year after 2015 any patient encounter of an eligible professional occurring at an eligible ambulatory surgical center shall not be treated as one in determining whether an eligible professional qualifies as a meaningful EHR user.

(Sec. 3) HHS shall establish a three-year demonstration program to test the use of value-based insurance design methodologies under the eligible Medicare Advantage (MA) plans offered by MA organizations under Medicare part C.

"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. 4) Payment amounts are prescribed for infusion drugs and biologicals furnished through durable medical equipment (DME) 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 the provision of 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 limits. (Sec. 6) $220 million shall be available to the Medicare Improvement Fund during and after FY2020.

(Sec. 7) DME competitive acquisition programs shall not cover infusion drugs and biologicals.

strengthening medicare_advantage innovation transparency seniors act sec bill amends title xviii medicare social_security_act ssact respect criteria qualifying meaningful user electronic health records meaningful ehr user payment year patient encounter eligible professional occurring eligible ambulatory surgical center shall treated determining eligible professional qualifies meaningful ehr user sec hhs shall establish year demonstration program test use value based insurance design methodologies eligible medicare_advantage plans offered organizations medicare 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 payment amounts prescribed infusion drugs biologicals furnished durable medical equipment dme january sec sense congress hhs incorrectly interpreted determination blended benchmark amounts prohibiting provision medicare quality incentive payments respect plans exceed payment benchmark cap area served plans immediately apply quality incentive payments respect plans regard limits sec million shall available medicare_improvement_fund fy2020 sec dme competitive acquisition programs shall cover infusion drugs biologicals