{"bills":[{"photos":{"featured":"https://assets.causes.com/bill/photo/s1961-114/featured_improving-the-treatment-of-the-u-s-territories-under-federal-health-programs-act-of-2015-1454551242.jpg","featured_large":"https://assets.causes.com/bill/photo/s1961-114/featured_large_improving-the-treatment-of-the-u-s-territories-under-federal-health-programs-act-of-2015-1454551242.jpg","shareable":"https://n.causes.com/share-images/bills/s1961-114.png"},"introduced_on":"2015-08-05","title_override":"Expanding Medicare and Medicaid into U.S. Territories","summary_override":"

This bill would eliminate disparities in Medicare and Medicaid coverage that disadvantage U.S. territories (like Puerto Rico, American Samoa, and Guam) when funds are disbursed to territorial governments and health care providers.

The cap on Medicaid funding for territories, and the limitation on the percentage of medical assistance the federal government can provide through Medicaid would be eliminated. All territories would be granted waiver authority for Medicaid, and the 100 percent of the federal poverty line limitation would be applied to all territories.

Territories would be included in the Medicaid disproportionate share hospital (DSH) program which provides additional funding to hospitals that treat a high percentage of low-income and uninsured patients. The formula used to compute DSH funding would also be changed for Puerto Rico to exclude the number patients enrolled in the federal Supplemental Security Income program which doesn’t cover the territory.

Base Medicare payment rates to hospitals in Puerto Rico would be adjusted upwards to ensure uniformity in base rates, as states all receive the same base rate. Puerto Rican hospitals would no longer be excluded from Medicare’s HITECH program, which allows hospitals that adopt electronic health records to receive bonus payments.

Physician compensation rates under Medicare would be subject to a new formula for calculating the geographic practice cost index (GCPI). A floor on Medicare payments under the GCPI would be established to help fairly compensate physicians in Puerto Rico.

Puerto Rico’s Medicare Advantage (MA) beneficiaries would receive additional compensation, as the territory’s MA plans would be covered by a payment floor.

","official_title":"A bill to amend titles XVIII and XIX of the Social Security Act to make improvements to the treatment of the United States territories under the Medicare and Medicaid programs, and for other purposes.","short_title":"Improving the Treatment of the U.S. Territories Under Federal Health Programs Act of 2015","popular_title":null,"short_summary":"Improving the Treatment of the U.S. Territories Under Federal Health Programs Act of 2015\n\nThis bill amends title XIX (Medicaid) of the Social Security Act (SSAct) to: (1) terminate limitations on general Medicaid funding, as well as the specific federal medical assistance percentage, for U.S. territories; (2) extend to additional U.S. territories the authority to waive or modify certain Medicaid requirements; and (3) establish a formula for Medicaid disproportionate share hospital (DSH) payments to the territories.\n\nFederal financial participation shall generally not be available to a territory for medical assistance for an individual whose family income exceeds 100% percent of the official poverty line for a family of that size.\n\nThe bill also amends title XVIII (Medicare) of the SSAct to: (1) revise the formula for the Medicare inpatient hospital services payment rate for hospitals in Puerto Rico to increase the applicable federal percentage from 75% to 100%, (2) apply Medicare HITEC...","summarized":true,"cost":null,"cost_commentary":"A CBO cost estimate is unavailable.","impact":"Medicare and Medicaid beneficiaries in U.S. territories, physicians and health care providers serving those beneficiaries, governments of U.S. territories, and the Centers for Medicare and Medicaid Services.","argument_for":"U.S. territories like Puerto Rico rely on Medicare and Medicaid to give their elderly and poor access to health care. 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Make your voice heard about the issues you care about. \r\n","page_title":"Federal Agencies Legislation - Vote on Bills, Stay informed, Hold Your Reps Accountable","icons":{"black":"https://assets.causes.com/issue/icon/federal-agencies/black_federal-agencies-1429042054.svg","grey":"https://assets.causes.com/issue/icon/federal-agencies/grey_federal-agencies-1429042054.svg","white":"https://assets.causes.com/issue/icon/federal-agencies/white_federal-agencies-1429042054.svg"},"cover_image_url":null,"is_following":false},{"id":"health","name":"Health","slug":"health","description":"Federal legislation around Health, encompassing: the Affordable Care Act, Medicare, Research into diseases (Cancer, HIV/Aids, Ebola), Drug safety, Hospital care and prescription drugs.","page_title":"Health Related US Federal legislation, including Medicare, ACA, and research - Vote on Bills, Stay informed, Hold Your Reps Accountable","icons":{"black":"https://assets.causes.com/issue/icon/health/black_health-1429042037.svg","grey":"https://assets.causes.com/issue/icon/health/grey_health-1429042037.svg","white":"https://assets.causes.com/issue/icon/health/white_health-1429042037.svg"},"cover_image_url":null,"is_following":false}],"users":[{"name":"Crystal","vote_count":31,"photos":{"large":"https://graph.facebook.com/10153542031921220/picture?width=150&height=150","small":"https://graph.facebook.com/10153542031921220/picture?width=75&height=75","tiny":"https://graph.facebook.com/10153542031921220/picture?width=20&height=20","facebook":"https://graph.facebook.com/10153542031921220/picture"},"links":{"following":"/api/users/OWly8A7Z/following","followers":"/api/users/OWly8A7Z/followers"},"about_me":null,"twitter_id":null,"facebook_id":null,"youtube_id":null,"google_plus_id":null,"website":null,"slug":null,"issue_count":31,"is_following":null,"influence_score":145,"influence_level":20,"follower_count":4,"following_count":4,"position_count":30,"id":"OWly8A7Z","partner_id":null}],"bill_position":{"flagged":false,"id":"a3d8bce6-3853-47b2-8b6e-3c6773809d5d","argument_for":"Of course! They're territories for a reason. If I was leader of a territory and the U.S. wouldn't give my disabled constituents the free/affordable healthcare they needed, I would try to secede and create an autonomous state.","argument_against":null,"show_argument_for":true,"show_argument_against":false,"upvote_count":0,"upvotes_for_count":0,"upvotes_against_count":null,"has_upvoted":false,"endorsement_count":0,"links":{"self":"https://www.causes.com/positions/a3d8bce6-3853-47b2-8b6e-3c6773809d5d"},"body":"Of course! They're territories for a reason. If I was leader of a territory and the U.S. wouldn't give my disabled constituents the free/affordable healthcare they needed, I would try to secede and create an autonomous state.","stance":"yea","created_at":"2016-03-31T23:31:02.829Z","shareable_image_url":"https://n.causes.com/share-images/positions/a3d8bce6-3853-47b2-8b6e-3c6773809d5d.png","note_color":null,"note_text":null,"bill_id":"s1961-114","user_id":"OWly8A7Z","endorser_ids":[]}}

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Expanding Medicare and Medicaid into U.S. Territories