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S. 5269IntroducedSenate · nowHousePresidentLawIn committee
Sec. 4 · S. 5269

Reducing beneficiary cost sharing for primary care services

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(a) In general Notwithstanding any other provision of law, the Secretary of Health and Human Services (in this section referred to as the Secretary) may reduce by 50 percent any beneficiary cost sharing otherwise applicable under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.) for primary care services that are reimbursed through the hybrid payments established under section 3, provided that the beneficiary designates a primary care provider as their usual source of care and informs the Secretary of who that provider is pursuant to the procedures established under section 3(e). (b) Report to Congress Not later than 180 days after the date on which subsection (a) is first implemented, and annually thereafter, the Secretary shall submit to Congress a report on the implementation of such subsection, including an analysis of— (1) whether the reduction of beneficiary cost-sharing under such subsection has impacted beneficiary utilization of primary care services that may be reimbursed through the newly established per-member-per-month payment; and (2) whether the Secretary has observed any instances of fraud or abuse associated with the reduction of such cost-sharing, and whether the Secretary has taken steps to minimize any such fraud or abuse.

Sec. 4: Reducing beneficiary cost sharing for primary care services · Public Law Tracker