Number:  114-5
Date:  April 21, 2015

House Passes H.R. 2,
Medicare Access and CHIP Reauthorization Act of 2015
         

On April 16, 2015, the President signed into law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, which became Public Law 114-10.  The Senate passed the bill on April 14, 2015 by a vote of 92-8, without amendment.  The bill previously passed the House on March 26, 2015 by a vote of 392-37.  The law, among things, reauthorizes the Children’s Health Insurance Program (CHIP) and repeals the Medicare sustainable growth rate.1

Following are provisions of interest to the Social Security Administration (SSA):

Prohibition of Inclusion of Social Security Account Numbers on Medicare Cards

• Requires the Secretary of Health and Human Services (the Secretary), in consultation with the Commissioner of Social Security (Commissioner), to establish:

• Procedures to ensure that a Social Security Number (SSN) or an SSN-derivative is not displayed, coded, or embedded on the Medicare card.

• An implementation process that minimizes disruptions and provides necessary assistance to Medicare beneficiaries and health care providers, such as providing a toll-free phone number and outreach to providers.

• Requires the Secretary and the Commissioner to consider implementing a Medicare beneficiary identifier that is not an SSN or an SSN-derivative for use with healthcare providers and entities external to the Department of Health and Human Services and SSA.

• Requires the Secretary to provide $320 million for implementation funding over 3 years to the Centers for Medicare and Medicaid Services (CMS), the Railroad Retirement Board (RRB), and SSA from the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds2 as follows:

• CMS—$219 million.  $65 million in fiscal year (FY) 2015, $53 million in FY 2016, and $53 million in FY 2017, (all available through FY 2018); and $48 million in FY 2018 (available until expended).
  
  
• SSA—$98 million.  $27 million in FY 2015, $22 million in FY 2016, and $22 million in FY 2017, (all available through FY 2018); and $27 million in FY 2018 (available until expended).
  
  
• RRB—$3 million.  $3 million in FY 2015, to be made available until expended.
  
  
• Requires the Secretary to specify an effective date for implementation of these provisions that is no later than four years after the date of enactment.

• Requires the Secretary to provide for the reissuance of Medicare cards that comply with the new requirements not later than four years after the effective date specified by the Secretary.

Permanent Extension of the Qualifying Individual (QI) program

• Permanently extends the QI program.3
  

• Allocates $535 million from April 1, 2015 through December 31, 2015, and $980 million for 2016.

• Authorizes the Secretary to increase the allocation amount under certain conditions for a year (beginning with 2017).

Income-Related Premium Adjustment for Medicare Parts B and D

• Modifies the table for the applicable percentage in premiums, increasing the amount that individual enrollees are required to pay for Medicare Parts B and D, based on modified adjusted gross income (MAGI) to the following4:

• Makes the amended table effective for calendar year 2018.

• Increases the threshold amounts (income brackets), beginning with calendar year 2020, by the percentage change, if any, of the average Consumer Price Index for all urban consumers between the 12-month period ending with August of the preceding calendar year and the corresponding 12-month period ending in August 2018.

Consideration of Measures Regarding Medicare Beneficiary Smart Cards

• Requires the Secretary to determine whether it is cost effective and technologically viable to use electronic Medicare beneficiary and provider cards.

• Requires the Secretary to consider such measures as determined appropriate to implement the use of electronic Medicare beneficiary and provider cards, to the extent that the Secretary determines that these cards are cost effective and technologically viable.

• Requires the Secretary to submit to the House Committees on Ways and Means, Energy, and Commerce, and the Senate Committee on Finance, a report outlining any consideration given to the measures to implement the use of such cards if the Secretary considers any such measures.

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1 Provision often known as the “doc fix.”

2 The law would not provide any new appropriations for implementation, but rather designate the amount of funding the Secretary must transfer from HHS trust funds to CMS, and when the Secretary must make such funds available.

3 Under the QI program, individuals with income between 120 percent and 135 percent of the federal poverty level may be eligible for payment of their Medicare Part B premiums.  Individuals must apply with the State annually, and must not be eligible for any other form of Medicaid.

4 Under current law, the MAGI range starts at “more than $85,000” and ends at “more than $214,000.”