H.R. 6365, The Medicare Special Needs Plans Extension and Amendments Act of 2008

• This item is from the 110th Congress (2007-2008) and is no longer current. Comments, voting, and wiki editing have been disabled, and the cost/savings estimate has been frozen.

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H.R. 6365 would amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals.

Detailed Summary

Medicare Special Needs Plans Extension and Amendments Act of 2008 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to extend the authority to restrict enrollment for specialized Medicare Advantage (MA) plans for special needs individuals.

Redefines “specialized MA plan for special needs individuals” to require targeted enrollment of high-risk groups.

Directs the Secretary of Health and Human Services to enter into agreements with states to coordinate the financing of specialized MA plans for special needs individuals for enrollees entitled to medical assistance under state Medicaid plans.

Establishes additional requirements for dual special needs plans (SNPs) as well as for severe or disabling chronic condition SNPs.

Directs the Secretary to evaluate for Congress the adequacy of the MA risk adjustment system for high-risk, high cost beneficiaries.

Authorizes the Secretary to modify rules, policies, and procedures under SSA titles XVIII and XIX (Medicaid) to provide for alignment of Medicare and Medicaid requirements for dual eligibles, particularly in the oversight of SNPs serving such dual eligibles.

Directs the Secretary to etablish or designate an Office on Medicare/Medicaid Integration to align Medicare and Medicaid policies and procedures and develop tools to support state integration efforts for dual eligible access to Medicare and Medicaid benefits and services.

Status of the Legislation

Latest Major Action: 6/30/2008: Referred to House subcommittee. Status: Referred to the Subcommittee on Health.

Points in Favor

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Points Against

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