LEGISLATION | OCTOBER 11, 2017 | BY PETER NOTARSTEFANO

H.R 4006, sponsored by U.S. Representatives Linda Sanchez (D-CA), Pat Meehan (R-PA), Leonard Lance (R-NJ) and Kurt Schrader (D-OR), would create a Community-Based Institutional Special Needs Plan (CBI-SNP) Demonstration to help frail, low-income Medicare beneficiaries remain in their homes and avoid costly nursing home care that frequently leads to impoverishment. Ask your Representatives and Senators to co-sponsor the Community Based Independence for Seniors Act.

LeadingAge praises Senator Ben Cardin (D-MD) and Senator Chuck Grassley (R-IA) for re-introducing their bipartisan legislation, the Community Based Independence for Seniors Act, S. 309, as well as Reps. Linda Sanchez, Patrick Meehan, Leonard Lance (R-NJ) and Kurt Schrader (D-OR) for introducing the Community Based Independence for Seniors Act, H.R. 4006. in the U.S. House of Representatives. This legislation would establish a new Community-Based Institutional Special Needs Plan (CBI-SNP) demonstration program. This program would target home and community-based services for low-income, Medicare-only beneficiaries who need help with 2 or more activities of daily living. The benefit would include long-term care services and supports, that the Secretary of HHS determines appropriate for the purpose of the CBI-SNP demonstration program, such as:

(A) homemaker services;

(B) home delivered meals;

(C) transportation services;

(D) respite care;

(E) adult day care services;

(F) non-Medicare-covered safety and other equipment.

The demonstration would operate in up to 5 states initially, building on Medicare Advantage plans that have experience caring for this frail population. The plans would tailor services to beneficiaries, depending on individual needs. For instance, they might provide adult day services for individuals that need assistance with the medications or who may benefit from socialization and recreational activities.

The demonstration would generate evidence to support an alternative payment methodology that could produce savings for both states and the federal government. One estimate shows 4-year savings of nearly $60 million for a demonstration of 5,000 Medicare members by postponing or preventing hospitalization and institutionalization.

The bill will be assigned to the Senate Finance Committee and the House Ways and Means Committee. Ask your Representatives and Senators to co-sponsor the Community Based Independence for Seniors Act.