S-2197 : Still Just a Bill

Securing Care for Seniors Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare & Medicaid Services (CMS) to periodically revise the Medicare Advantage (MA) risk adjustment system, such that an individual's risk score takes into account the number of chronic conditions with which the individual has been diagnosed.

In addition, CMS must evaluate the impacts to the system of: (1) using two years of data, (2) removing diagnostic codes related to chronic kidney disease, and (3) modifying the use of encounter data (information on services furnished to MA enrollees). If CMS subsequently determines that any of these revisions would better reflect the population served, CMS shall make such revisions. Before doing so, however, CMS must: (1) ensure that the changes do not prevent an MA organization from performing activities that are consistent with national health policy goals, and (2) provide an opportunity for review and public comment.