Sec. 6084. Studying the availability of supplemental benefits designed to treat or prevent substance use disorders under Medicare Advantage plans
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Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall submit to Congress a report on the availability of supplemental health care benefits (as described in section 1852(a)(3)(A) of the Social Security Act ( 42 U.S.C. 1395w–22(a)(3)(A) )) designed to treat or prevent substance use disorders under Medicare Advantage plans offered under part C of title XVIII of such Act. Such report shall include the analysis described in subsection
(c)and any differences in the availability of such benefits under specialized MA plans for special needs individuals (as defined in section 1859(b)(6) of such Act ( 42 U.S.C. 1395w–28(b)(6) )) offered to individuals entitled to medical assistance under title XIX of such Act and other such Medicare Advantage plans. The Secretary shall develop the report described in subsection
(a)in consultation with relevant stakeholders, including— individuals entitled to benefits under part A or enrolled under part B of title XVIII of the Social Security Act; entities who advocate on behalf of such individuals; Medicare Advantage organizations; pharmacy benefit managers; and providers of services and suppliers (as such terms are defined in section 1861 of such Act ( 42 U.S.C. 1395x )). The report described in subsection
(a)shall include an analysis on the following: The extent to which plans described in such subsection offer supplemental health care benefits relating to coverage of— medication-assisted treatments for opioid use, substance use disorder counseling, peer recovery support services, or other forms of substance use disorder treatments (whether furnished in an inpatient or outpatient setting); and non-opioid alternatives for the treatment of pain. Challenges associated with such plans offering supplemental health care benefits relating to coverage of items and services described in subparagraph
(A)or
(B)of paragraph (1). The impact, if any, of increasing the applicable rebate percentage determined under section 1854(b)(1)(C) of the Social Security Act ( 42 U.S.C. 1395w–24(b)(1)(C) ) for plans offering such benefits relating to such coverage would have on the availability of such benefits relating to such coverage offered under Medicare Advantage plans. Potential ways to improve upon such coverage or to incentivize such plans to offer additional supplemental health care benefits relating to such coverage.
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U.S. Code
3 references not yet in our index
- 42 USC 1395w–22(a)(3)(A)
- 42 USC 1395w–28(b)(6)
- 42 USC 1395w–24(b)(1)(C)
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Sec. 6084
Studying the availability of supplemental benefits designed to treat or prevent substance use disorders under Medicare Advantage plans
Cite42 USC 1395w–22(a)(3)(A)
Cite42 USC 1395w–28(b)(6)
Cite42 USC 1395w–24(b)(1)(C)
Cites 4Cited by 0 across 0 sources