[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5681 Introduced in House (IH)]
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114th CONGRESS
2d Session
H. R. 5681
To require the Center for Medicare and Medicaid Innovation to test the
efficacy of providing Alzheimer's Disease caregiver support services in
delaying or reducing the use of institutionalized care for Medicare
beneficiaries with Alzheimer's Disease or a related dementia.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 7, 2016
Ms. Linda T. Sanchez of California (for herself and Mr. Roskam)
introduced the following bill; which was referred to the Committee on
Ways and Means, and in addition to the Committee on Energy and
Commerce, 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 require the Center for Medicare and Medicaid Innovation to test the
efficacy of providing Alzheimer's Disease caregiver support services in
delaying or reducing the use of institutionalized care for Medicare
beneficiaries with Alzheimer's Disease or a related dementia.
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 ``Alzheimer's Beneficiary and
Caregiver Support Act''.
SEC. 2. TESTING OF MEDICARE AND MEDICAID COVERAGE OF ALZHEIMER'S
DISEASE CAREGIVER SUPPORT SERVICES.
Section 1115A of the Social Security Act (42 U.S.C. 1315a) is
amended--
(1) in subsection (b)(2)--
(A) in subparagraph (A), by adding at the end the
following new sentence: ``The models selected under
this subparagraph shall include the model described in
subparagraph (D), which shall be implemented by not
later than the date that is 1 year after the date of
enactment of such subparagraph.''; and
(B) by adding at the end the following new
subparagraph:
``(D) Alzheimer's disease caregiver support
services model.--The model described in this
subparagraph is a model that meets the requirements of
subsection (h) with respect to coverage of, and payment
for, Alzheimer's Disease caregiver support services (as
defined in such subsection).''; and
(2) by adding at the end the following new subsection:
``(h) Coverage of Alzheimer's Disease Caregiver Support Services.--
``(1) In general.--Subject to the succeeding provisions of
this subsection, for the 3-year period that begins on January
1, 2018, the Secretary shall test the efficacy of coverage of,
and payment for, Alzheimer's Disease caregiver support services
(as defined in paragraph (2)) under the applicable title, in
delaying or reducing the use of institutionalized care for
applicable Medicare beneficiaries (as defined in paragraph
(3)).
``(2) Definition of alzheimer's disease caregiver support
services.--In this subsection, the term `Alzheimer's Disease
caregiver support services' means the following services
furnished by an eligible professional (as defined in paragraph
(3)) to a family caregiver (as defined in such paragraph) of an
applicable Medicare beneficiary (as defined in such paragraph):
``(A) A defined set of counseling sessions over a
fixed period of time (as determined appropriate by the
Secretary), including a comprehensive baseline
interview, two individual counseling sessions, and four
family counseling sessions.
``(B) Following such defined set of counseling
sessions, a subsequent period (as determined
appropriate by the Secretary) of follow-up assessments,
support group participation, and ad hoc counseling or
consultations to support the family caregiver as needs
arise and the health of the applicable Medicare
beneficiary changes.
``(3) Additional definitions.--In this subsection:
``(A) Applicable medicare beneficiary.--The term
`applicable Medicare beneficiary' means an individual--
``(i) who is entitled to benefits under
part A and enrolled under part B of title XVIII
who is not enrolled in a Medicare Advantage
plan under part C of such title, an eligible
organization under section 1876, or a PACE
program under section 1894; and
``(ii) who has been diagnosed with
Alzheimer's Disease or a related dementia.
``(B) Eligible professional.--The term `eligible
professional' means an individual who--
``(i) is a clinical social worker (as
defined in section 1861(hh)(1)) or a nurse
practitioner (as defined in section
1861(aa)(5)(A)); and
``(ii) has undergone extensive online
training in the best practices for caregiver
intervention for patients who have been
diagnosed with Alzheimer's Disease or a related
dementia.
``(C) Family caregiver.--The term `family
caregiver' means, with respect to an applicable
Medicare beneficiary, a spouse, adult child, or other
family member of the applicable Medicare beneficiary
who is part of the care team of the applicable Medicare
beneficiary and receives no monetary compensation for
their service as part of the team.
``(4) Payment.--The Secretary shall establish payment
amounts under this subsection for Alzheimer's Disease caregiver
support services.
``(5) Number of family caregivers furnished alzheimer's
disease caregiver support services.--The Secretary shall select
a sufficient number of eligible professionals to participate in
the model under this subsection to ensure that the primary
family caregiver and at least one other, informal family
caregiver of applicable Medicare beneficiaries receive
Alzheimer's Disease caregiver support services under this
subsection.''.
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