Revised Community Based Independence for Seniors Act Introduced

Legislation | March 23, 2015 | by

A revised version of the Community Based Independence for Seniors Act was introduced by Rep. Linda Sanchez D-CA, Rep. Leonard Lance (R-NJ), Rep. Patrick Meehan (R-PA), and Rep. Kurt Schrader (D-OR). 
 

H. R. 4212 would establish a Community-Based Institutional Special Needs Plan demonstration program to target home and community-based care to eligible Medicare beneficiaries. This legislation would establish a Community-Based Institutional Special Needs Plan demonstration program to target home and community-based care to eligible Medicare beneficiaries, and for other purposes.

Changes made to the Community Based Independence for Seniors Act

The Secretary shall establish payment rates for eligible MA organizations offering eligible MA plans under the CBI-SNP demonstration program for benefits covered under such program (and not otherwise covered under part C) and provided to eligible Medicare beneficiaries under such plans. Such payment rates shall--

 

  1. Be based upon payment rates established for purposes of payment under section 1853.
  2. Be in addition to payments otherwise made to such organization with respect to such plans under part C.
  3. Be adjusted to reflect the costs of treating eligible Medicare beneficiaries under this section.
  4. Not, with respect to a month in which an eligible MA organization provides home and community-based care to eligible Medicare beneficiaries under such demonstration program, exceed an amount for such month that is equal to the amount that would be awarded to such organization if the organization were to receive $400 with respect to each such beneficiary that the organization provides with such care during such month.

 

LeadingAge strongly supports this legislation that would allow Medicare beneficiaries that have care needs to receive adult day services, non emergency transportation and meal programs within a demonstration program. We thank Rep. Linda Sanchez D-CA, Rep. Leonard Lance (R-NJ), Rep. Patrick Meehan (R-PA), and Rep. Kurt Schrader (D-OR) for their dedication to help older adults receive the care they require to remain in the community. 

The Community Based Independence for Seniors Act of 2015 has been introduced in both houses of Congress. The measure would establish a Community-Based Institutional Special Needs Plan (CBI-SNP) demonstration to target home and community-based (HCBS) care to eligible Medicare beneficiaries in 5 states. 

Rep. Linda Sanchez (D-CA) and Rep. Patrick Meehan (R-PA) introduced H.R. 2704, which was referred to both the Committee on Ways and Means, and the Committee on Energy and Commerce. 

Sen. Chuck Grassley (R-IA) and Sen. Ben Cardin (D-MD) introduced the U.S. Senate version, S. 704. The Finance Committee is expected to take up that bill during the week of June 22. 

On June 24, the Senate Finance Committee unanimously passed 12 bills, including Community Based Independence fore Seniors Act (S. 704), as modified. 

The legislation would now move to the full Senate for a vote. 

The modified version of the bill would authorize the Medicare Advantage plans  participating in the CBI-SNP demonstration to use their rebate dollars to provide eligible enrollees with supplemental benefits, such as adult day services. The original legislation would have created a benchmark payment for the Medicare Advantage plans separate from their Medicare Part C payment.  

Provisions in S. 704

The following provisions are included in the Senate legislation: 

  • The secretary shall enter into agreements with up to 5 Medicare Advantage plans to conduct the Community Based Independence Special Needs Plan (CBI-SNP) demonstration program. Each such MA plan may enroll up to 1,000 eligible Medicare beneficiaries (including new enrollees) in such program.
  • Under the CBI-SNP demonstration program, eligible Medicare beneficiaries shall receive the following benefits, in addition to those already covered under Medicare Advantage programs: Long-term care services and supports, that the secretary determines appropriate for the purposes of the CBI-SNP demonstration program, such as:
     
    • Homemaker services.
    • Home delivered meals.
    • Transportation services.
    • Respite care.
    • Adult day care services.
    • Non-Medicare-covered safety and other equipment.
     
  • An evaluation of the Community Based Independence Special Needs Plan (CBI-SNP) demonstration program and Report to Congress no later than 4 years after implementation of the demonstration.

“One estimate shows 4-year savings of nearly $60 million for a demonstration of 5,000 Medicare members by postponing or preventing hospitalization and institutionalization,” Sen. Grassley said.