Senior Access to Vaccines Ensured Act of 2021 or the SAVE Act of 2021
This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a program that provides nonemergency medical transportation (NEMT) for Medicare beneficiaries to COVID-19 vaccination sites during the public health emergency. The CMS must contract with qualified transportation managers to implement the program, with preference given to those with prior experience under a state Medicaid NEMT program. The CMS must also establish criteria for beneficiary participation that is similar to the criteria used by states for Medicaid NEMT services.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2080 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 2080
To amend title XVIII of the Social Security Act to provide for
temporary coverage of certain transportation services for certain
individuals under the Medicare program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 19, 2021
Mr. Bishop of Georgia (for himself, Mr. Carter of Georgia, Mr.
Cardenas, Mr. Griffith, Mr. Grijalva, Ms. Pressley, Mr. Cohen, Mr.
Levin of California, Mr. Carbajal, and Ms. Sewell) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for
temporary coverage of certain transportation services for certain
individuals under the Medicare program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Senior Access to Vaccines Ensured
Act of 2021'' or the ``SAVE Act of 2021''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The Kaiser Family Foundation reported that only about
12 percent of Medicare beneficiaries are full Medicare-Medicaid
dual eligibles and, thus, have Medicaid coverage for
nonemergency medical transportation (NEMT) to access COVID-19
vaccination appointments and other health care appointments.
According to the Commonwealth Fund, although 45 percent of
Medicare beneficiaries have incomes lower than 200 percent of
the federal poverty level (FPL), which can limit their
transportation options, Medicare does not currently cover NEMT.
(2) Medicare beneficiaries over the age of 65, according to
the Centers for Disease Control, are 24 times more likely to
die from COVID-19 than an adult aged 25-54.
(3) A managed NEMT benefit that offers scheduling and other
assistance would improve beneficiaries' access to the COVID-19
vaccine. It also would reduce Medicare expenditures by covering
more cost-effective alternatives and avoiding the high cost of
in-patient COVID-19 treatment.
SEC. 3. COVERAGE OF MANAGED, NONEMERGENT TRANSPORTATION SERVICES FOR
CERTAIN INDIVIDUALS.
Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is
amended by adding at the end the following new section:
``SEC. 1899C. MANAGED, NONEMERGENT TRANSPORTATION SERVICES BENEFIT
PROGRAM.
``(a) Establishment.--The Secretary shall establish a program to be
known as the `Managed, Nonemergent Transportation Services Benefit
Program' for purposes of furnishing qualifying individuals not more
than 2 round-trip managed, nonemergent transportation services (as
defined in subsection (c)) to COVID-19 vaccination sites (including
community pharmacies) beginning April 1, 2021, and ending on the last
day of the emergency period described in section 1135(g)(1)(B).
``(b) Contract With Qualified Transportation Manager.--
``(1) In general.--For each medicare administrative
contractor jurisdiction for a year (beginning with 2021), the
Secretary shall enter into a contract with one qualified
transportation manager for purposes of arranging for the
provision of managed, nonemergent transportation services to
qualifying individuals in such region. Such contract shall
provide that payment be made by the Secretary for such service
on the basis of prepaid capitation payments (taking into
account the charge described in paragraph (2)(E)).
``(2) Selection.--Not later than 30 days after the date of
the enactment of this section, notwithstanding any other
provision of law, the Secretary shall award contracts described
in paragraph (1) through a competitive bidding process under
which the Secretary evaluates applicant entities based on
experience, past performance, references, available resources,
and cost for purposes of selecting qualified transportation
managers, with preference given to applicants with prior
satisfactory performance as a transportation broker under a
program described in section 1902(a)(70). Not later than 15
days after such date of enactment, the Secretary shall publish
guidance for prospective qualified transportation managers.
Such guidance shall include information on how such manager may
enter into a contract described in this subsection and a
description of terms and conditions applicable to such managers
with such contracts. Such a manager shall meet the following
requirements:
``(A) The manager establishes procedures meeting
criteria established by the Secretary for addressing
beneficiary complaints and ensuring network
transportation providers are licensed by the State for
purposes of operating vehicles and are competent and
courteous.
``(B) The manager is subject to regular audit and
oversight by the State in which such manager operates
in order to ensure the quality and timeliness of
transportation services managed and the adequacy of
qualifying individuals' access to medical care and
services.
``(C) The manager complies with all requirements
specified in the contract described in paragraph (1).
Such requirements shall include requirements related
to--
``(i) reviews and evaluations to ensure the
quality, appropriateness, and timeliness of
such services arranged by such manager;
``(ii) prohibitions on referrals and
conflict of interest as the Secretary shall
establish (based on the prohibitions on
physician referrals under section 1877 and such
other prohibitions and requirements as the
Secretary determines to be appropriate); and
``(iii) the development and implementation
of a corrective action plan to address any
contract deficiencies.
``(D) The manager establishes procedures for
determining an individual's eligibility for managed,
nonemergent transportation services under the program
established under subsection (a) using criteria
established by the Secretary under subsection (c)(3)
and for scheduling and organizing the furnishing of
such services.
``(c) Definition.--For purposes of this section:
``(1) Managed, nonemergent transportation services.--The
term `managed, nonemergent transportation services' means the
transportation of an individual by car, taxi, bus, or other
similar means (as specified by the Secretary) to a provider or
supplier of services where such individual is to be furnished
items or services payable under this title.
``(2) Qualified transportation manager.--The term
`qualified transportation manager' means an entity that
arranges, under contract with the Secretary, for the provision
of managed, nonemergent transportation services to qualifying
individuals.
``(3) Qualifying individual.--The term `qualifying
individual' means an individual entitled to benefits under part
A who is not enrolled under a Medicare Advantage plan under
part C and who is not a full-benefit dual eligible individual
(as defined in paragraph (4)) who has no readily-available
means of transportation (as determined by the Secretary). In
determining whether an individual has no readily-available
means of transportation for purposes of the previous sentence,
the Secretary shall establish criteria similar to those used by
States in making such determinations under a non-emergency
medical transportation program under a State plan under title
XIX (or a waiver of such plan), such as evaluating whether such
individual--
``(A) has a driver's license;
``(B) has a working vehicle available to such
individual at such individual's residence;
``(C) is incapable of driving due to a medical
condition; and
``(D) has inadequate financial resources to pay for
transportation.
``(4) Full-benefit dual eligible individual.--
``(A) In general.--The term `full-benefit dual
eligible individual' means for a State for a month an
individual who--
``(i) is entitled to benefits under part A
or enrolled under part B; and
``(ii) is determined eligible by the State
for medical assistance for full benefits under
title XIX for such month under section
1902(a)(10)(A) or 1902(a)(10)(C), by reason of
section 1902(f), or under any other category of
eligibility for medical assistance for full
benefits under such title, as determined by the
Secretary.
``(B) Treatment of medically needy and other
individuals required to spend down.--In applying
paragraph (1) in the case of an individual determined
to be eligible by the State for medical assistance
under section 1902(a)(10)(C) or by reason of section
1902(f), the individual shall be treated as meeting the
requirement of paragraph (1)(B) for any month if such
medical assistance is provided for in any part of the
month.
``(d) Funding.--The Secretary shall provide for the transfer, from
the Federal Supplementary Medical Insurance Trust Fund under section
1841 to the Centers for Medicare & Medicaid Services Program Management
Account, of such sums as may be necessary for purposes of carrying out
this section.
``(e) Clarification.--The provisions of section 1862(a) shall not
apply to payments made under a contract described in subsection
(b)(1).''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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