Medicare Advantage
H.R. 4872 REPEALED Sec. 3201 of H.R. 3950 that would have created a care coordination and management performance bonus for MA plans that implement programs, such as “health information technology programs, including clinical decision support and other tools to facilitate data collection and ensure patient-centered, appropriate care.”
H.R. 4872 adds:
Beginning in 2012, provides quality-based bonus payments to plans receiving 4 or more stars on a 5-star scale based on data currently collected. Provides for a 1.5 percent bonus in 2012; a 3 percent bonus in 2013; and a 5 percent bonus in 2014 and subsequent years. Provides for double bonuses for qualifying plans in qualifying counties. For plan years 2012-2014, phases in a modified beneficiary rebate system based on quality scores. As of 2014, plans with a quality rating of at least 4.5 stars can offer rebates (as offered now, in the form of additional benefits, reduced cost sharing, etc.) of 70 percent of the difference between the benchmark and the bid; for plans with 3.5-4.5 stars, 65 percent; and for plans with less than 3.5 stars, 50 percent. (Sec. 1102)
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