U.S. Rep. Mike Kelly (R-PA) is supporting a bipartisan bill to help save American taxpayers money by permitting low-income senior citizens to remain in their preferred health care setting.
“Keeping low-income seniors healthy and out of the hospital, which also saves taxpayer money, is a win for everyone. I am happy and proud to support this smart, bipartisan bill as its prime Republican sponsor,” Rep. Kelly said on Aug. 8 regarding the Community-Based Independence for Seniors Act of 2017, H.R. 4006.
Rep. Kelly in June replaced U.S. Rep. Patrick Meehan (R-PA) as the lead Republican cosponsor of H.R. 4006, which was introduced last October by U.S. Rep. Linda Sanchez (D-CA). U.S. Reps. Leonard Lance (R-NJ), John Katko (R-NY), Erik Paulsen (R-MN), and Rodney Davis (R-IL) also are cosponsors of H.R. 4006, which is the U.S. House version of the same-named S. 309. The U.S. Senate version was introduced on Feb. 6, 2017 by U.S. Sens. Chuck Grassley (R-IA) and Ben Cardin (D-MD).
The measure would establish a new Community-Based Institutional Special Needs Plan in Medicare Advantage focused on home and community-based services for low-income Medicare beneficiaries, according to a summary provided by Rep. Kelly’s office.
“In order to strengthen Medicare for all who rely on it, we must find more innovative ways to improve care and reduce costs,” said Rep. Kelly, who co-chairs the bipartisan Health Care Innovation Caucus, a congressional group he helped launch in March that aims to advance legislation around innovative policy ideas that improve the quality of health care and lower consumer costs.
“Studies show that enhanced coordinated care for low-income Medicare beneficiaries results in fewer hospital stays and readmissions,” the congressman said.
If enacted, the new pilot program created under H.R. 4006 would call for up to five eligible Medicare Advantage organizations to provide home and community-based care to eligible Medicare beneficiaries, according to the congressional record summary, which also noted that “for purposes of the demonstration program, an eligible Medicare beneficiary is ineligible for Medicaid and unable to perform two or more activities of daily living.”
Seniors would receive services specific to their needs, such as home-delivered meals, transportation, adult day-care services, and homemaker services, according to Rep. Kelly’s statement. The goal of H.R. 4006 is to enable seniors to age at home in their communities rather than moving to a costly nursing home.
H.R. 4006 also would authorize the Centers for Medicare and Medicaid Services (CMS) to establish capped payment rates for eligible Medicare Advantage plans under the pilot program; the rates would be in addition to payments otherwise made to Medicare Advantage organizations with respect to such plans, according to the congressional record.
Additionally, CMS would educate eligible Medicare beneficiaries on the program’s availability and ensure independent third-party evaluation of the program.
H.R. 4006 is supported by numerous stakeholders, including the Healthcare Leadership Council, the National Coalition on Health Care, SCAN Health Plan, and John Lovelace, president of UPMC For You, who said, “Congressman Kelly continues to be a leader in providing options and support for seniors in need.”
The lawmaker’s home state of Pennsylvania has the fifth-highest Medicare Advantage enrollment levels in the nation, Lovelace said, so H.R. 4006 could be especially valuable to the state’s chronically ill Medicare Advantage enrollees.
Another bill supporter, Katie Smith Sloan, president and CEO at LeadingAge, noted that providing senior citizens with daily activity assistance “is crucial to improving older adults’ health and quality of life while also increasing their ability to age in place.”
“LeadingAge urges Congress to enact the Community-Based Institutional Special Needs Plan demonstration program as outlined in H.R. 4006,” Sloan said. “The need for supports focused on activities of daily living is significant; addressing the need has potential of a significant positive impact on older adults at a relatively small cost.”
H.R. 4006 is under consideration by the U.S. House Energy and Commerce Committee and the House Ways and Means Committee. S. 309 is under consideration by the U.S. Senate Finance Committee.