To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models.
Impact
If enacted, HB 6369 will particularly affect the reimbursement framework for healthcare providers under Medicare, particularly those who qualify as participants in APMs. The proposed extension of incentive payments through 2026 aims to enhance the financial viability of these models, ultimately encouraging more providers to participate. This could lead to improved healthcare outcomes as more providers adopt APMs, promoting collaborative care strategies that prioritize patient health over the volume of services rendered.
Summary
House Bill 6369 aims to amend title XVIII of the Social Security Act by extending incentive payments for healthcare providers participating in eligible alternative payment models (APMs). The bill seeks to ensure continued financial incentives for providers who adhere to these models, which are designed to promote higher quality care while controlling costs. By extending these payments, the bill supports the ongoing implementation and sustainability of APMs, reflecting a shift from traditional fee-for-service payment structures towards more innovative and integrated care approaches.
Contention
While the bill has gained traction among supporters who advocate for enhancing quality healthcare delivery, there are concerns about the long-term sustainability of the incentive structures. Some critics argue that the bill may lead to financial complexities or challenges in ensuring equitable access to care. Moreover, debate continues around the appropriate balance between incentivizing providers and maintaining rigorous oversight to ensure these programs are effectively improving patient outcomes without unnecessary costs.
To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models under the Medicare program.
To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program.
To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program.
To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid.
To amend title XVIII of the Social Security Act to provide for the guaranteed issue of Medigap policies to all Medigap-eligible Medicare beneficiaries and Medicare Advantage enrollees, and for other purposes.