Section 1 Short title
This Act may be cited as the “Preventive Services Medicare Parity Act of 2016”.
Preventive Services Medicare Parity Act of 2016
A BILL
To amend title XVIII of the Social Security Act to provide Medicare coverage of preventive services that are required to be covered by group and individual health plans.
Sec. 2 Medicare coverage of preventive services that are required to be covered by group and individual health plans
In general— Paragraph (1) of section 1861(ddd) of the Social Security Act (42 U.S.C. 1395x(ddd)) is amended by striking “means services not described” and all that follows through the period at the end and inserting the following:
“(A) are not described in subparagraph (A) or (C) of paragraph (3); and
“(B) with respect to services furnished to an individual during a calendar year, would be required, under section 2713(a)(1) of the Public Health Service Act, to be covered with respect to such individual if such individual were enrolled under group or individual health insurance coverage for a plan year consisting of such calendar year.”
Authority for a national coverage determination where predicted outcomes for services are not commensurate with expenditures— Paragraph (2) of section 1861(ddd) of the Social Security Act (42 U.S.C. 1395x(ddd)) is amended to read as follows:
“(2) The Secretary may conduct, with respect to an additional preventive service, an assessment of the relation between the predicted outcomes and the expenditures for such service with respect to individuals enrolled under part B. If the Secretary determines, based on the results of such assessment, that the predicted outcomes for such service would not be commensurate with the expenditures for such service, the Secretary may use the process for making a national coverage determination (as defined in section 1869(f)(1)(B)) to exclude such service from coverage nationally on such basis.”
Effective date— The amendments made by this section shall apply with respect to services furnished on or after January 1, 2018.