AHFA Amendments
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SenatorPartySummary OffsetCategoryNo.
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RockefellerDClarification of the Members of the Quality Improvement Coordinating Council Budget NeutralDelivery system1
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RockefellerDRe-defining primary care to include geriatricians, palliative care and mental health for the purposes of improving access to primary care Capping itemized deductions at 35%Delivery system2
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RockefellerDAdd a new Part V - Health Information Technology; add free clinics to the list of providers eligible for Medicare and Medicaid incentives under the American Recovery and Reinvestments Act of 2009 Capping itemized deductions at 35%Delivery system3
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RockefellerDCreate a new Part V - Health Information Technology; require third-party audits of health information technology Capping itemized deductions at 35%Delivery system4
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RockefellerDCreate a new Part V - Health Information Technology, add advance planning language Capping itemized deductions at 35%Delivery system5
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RockefellerDEliminate discriminatory prescription drug cost-sharing for individuals with chronic disease Capping itemized deductions at 35%Delivery system6
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RockefellerDImprovements to the Medicare prescription drug program Capping itemized deductions at 35%Delivery system7
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RockefellerDNCQA Quality standards for Medicare Advantage Special Needs Plans (SNPs) Delivery system8
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RockefellerDEliminate all overpayments to Medicare Advantage private plans Delivery system9
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RockefellerDAmendment to the Medicare Commission Provision This amendment is a net-saverDelivery system10
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RockefellerDCreate a New Subtitle I - Sense of the Senate Regarding Long Term Care Sense of the Senate, no offset requiredDelivery system11
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RockefellerDCreation of an All Payer Anti-Fraud Program with a Revolving Fund to Provide Incentives for anti-Fraud Activities for the States and for Health Plans As stated in the amendmentDelivery system12
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ConradDExpand CMS Innovation Center criteria to Promote Quality Improvement and Efficiency N/ADelivery system13
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ConradDMedicare Pilot Program to Improve Patient Care and Achieve Cost Savings TDBDelivery system14
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ConradDExpand the CMS Innovation Center to Facilitate Local Inpatient Treatment of Acutely Ill Medicare Beneficiaries This amendment has no cost.Delivery system15
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ConradDNurse Midwifery Access and Reimbursement Equity TBDDelivery system16
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ConradDTwo-year Extension of "Super Rural" Bonus Payment for Ambulance Services TBDDelivery system17
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ConradDEnsuring Long-Term Health Savings The amendment would not affect health spending in the ten-year budget window (2010 - 2019) but could reduce spending in years after 2019.Delivery system18
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ConradDMedicare Part D Limited Manufacturer Cost Sharing Assistance TBDDelivery system19
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BingamanDTechnical Amendment for 340B Discount drugs Budget NeutralDelivery system20
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BingamanDEnsuring GME Redistribution is available to Rural and Other Underserved States Budget NeutralDelivery system21
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BingamanDImproving Access to Rural Hospital care by Modifying Criteria for Critical Access Hospitals Commensurate acceleration in the reduction in MA IME payments provided for in the Medicare Improvements for Patients and Providers Act of 2008Delivery system22
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BingamanDProtection for low-income Seniors and other Medicare beneficiaries Proportionately increase the annual fees on health insurance providers; manufacturers and importers of branded drugs; manufacturers and importers of medical devices; and clinical laboratories in the Chairman's Mark by an amount commensurate with the cost associated with this amendmentDelivery system23
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BingamanDProtection for Appropriate Medicare Payment Levels by Establishing a Prospective Payment System for Services Furnished by Federally Qualified Health Centers Eliminate provision in the Chairman's Mark that, beginning January 1, 2013, requires states to offer premium assistance and wrap-around benefits to Medicaid beneficiaries who are offered employer-sponsored insurance if it is cost-effective.Delivery system24
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BingamanDNational Health Care Workforce Commission Budget NeutralDelivery system25
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BingamanDEstablishing "Teaching Health Centers" to Increase the Number of Primary Care Physicians Commensurate increase in annual insurance fee.Delivery system26
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BingamanDEnsures appropriate consolation with mental health and substance abuse experts and better coordination of mental illness and substance abuse treatment Budget NeutralDelivery system27
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KerryDEnsure Consumer and Patient Involvement in Decisions affecting the Delivery of Health Care This amendment will not result in increased cost.Delivery system28
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Kerry/ StabenowD/DEasing the Impact of Home Health Cuts Amendment will be offset by closing corporate tax loopholesDelivery system29
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KerryDEnabling Physicians from Various Specialties to Participate in Accountable Care Organizations This amendment will not result in increased cost.Delivery system30
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KerryDPediatric Accountable Care Organization Demonstration Project under Medicaid and CHIP This amendment should result in a reduced cost.Delivery system31
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KerryDInclusion of Medicaid and CHIP in CMS Innovation Center This amendment will not result in increased cost.Delivery system32
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LincolnDImproving access to primary and preventive care by adding a modified version of the Medicare Fracture Prevention and Osteoporosis Testing Act (S. 769). Extend Medicare Secondary Payer (MSP) for privately-insured dialysis patients to Medicare after 30 months by amount necessary to offset the increase in spending.Delivery system33
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LincolnDImproving access to primary and preventive care by adding a modified version of the Medicare Fracture Prevention and Osteoporosis Testing Act (S. 769). Extend Medicare Secondary Payer (MSP) for privately-insured dialysis patients to Medicare after 30 months by amount necessary to offset the increase in spending.Delivery system34
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LincolnDIncrease health care workforce accessibility for Medicare beneficiaries with mental illness by adding the Seniors Mental Health Access (S.671) and the Clinical Social Work Medicare Equity Act (S. 687) Health and Human Services/Office of the Inspector General Redbook (May 2009): Ensure Appropriateness of Medicare Payments for Mental Health ServicesDelivery system35
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LincolnDTo allow Medicare beneficiaries enrolled in MA or MA-PD plans to return to original Medicare in the first 45 days of the Calendar year To be determinedDelivery system36
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Lincoln/HatchD/RTo create a comprehensive approach to ensuring adequate public-private infrastructure and resolving to prevent, detect, treat, understand, intervene in, and where appropriate, aid in the prosecution of, elder abuse, neglect, and exploitation - by adding the Elder Justice Act (S. 795) to The America's Healthy Future Act To be providedDelivery system37
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LincolnDTo restore the ratios used in determining geographic hospital wage index reclassification to the pre-October 1, 2008 levels until the first fiscal year on year after the secretary makes a proposal(s) that considers the nine points specified in the Tax Relief and Health Care Act of 2006 N/ADelivery system38
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LincolnDProvide access to home infusion therapy services for Medicare beneficiaries by adding the Home Infusion Therapy Coverage Act (S.254). To be determinedDelivery system39
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LincolnDTo Allow Critical Access Hospitals (CAHs) to access Medicare Disproportionate Share Hospital (DSH) funding proportionate to their level of uncompensated care. To be determinedDelivery system40
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LincolnDTo authorize qualified physical therapists in rural areas to provide services for Medicare beneficiaries without the requirement of a physician referral. To be determinedDelivery system41
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LincolnDTo revise Medicare coverage to permit respiratory therapists to work under the general supervision of the physician and to recognize respiratory therapists who work outside of the hospital. To be determinedDelivery system42
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LincolnDTo overturn the Centers for Medicare and Medicaid Services’ (CMS’) CY 2010 Physician Fee Schedule Proposed Rule’s application of equipment utilization policy to radiation therapy. The amendment would be exempt from budget neutrality requirements under the statute. To be providedDelivery system43
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WydenDEnsuring People in Hospice Do not Have to Give Up the Prospect of a Cure This amendment will not result in increased cost.Delivery system44
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WydenDThe Independence at Home (IAH) Act, S. 1131, seeks to provide high cost Medicare beneficiaries suffering from multiple chronic conditions with coordinated, primary care services in their homes or residences from a team of qualified health care professionals. This amendment will not result in increased cost.Delivery system45
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WydenDEmpowering Medicare Patient Choices Reduce market baskets uniformly across Medicare Part B as needed to offset the increases.Delivery system46
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WydenDMedicare Efficiency and Fairness This amendment will not result in increased cost.Delivery system47
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WydenDHealth Homes This amendment will not result in increased cost.Delivery system48
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WydenDRural Health Clinic Patient Access and Improvement Act Create a specific exemption to allow health plan sponsors to encourage beneficiaries to utilize lower-cost generic drugsDelivery system49
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WydenDAmends Title XVIII of the Social security act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans. Create a specific exemption to allow health plan sponsors to encourage beneficiaries to utilize lower-cost generic drugsDelivery system50
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WydenDRural Health Clinic Patient Access and Improvement and Critical Access Hospital Flexibility Act. Create a specific exemption to allow health plan sponsors to encourage beneficiaries to utilize lower-cost generic drugsDelivery system51
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WydenDThe Confidence in Long-Term Care Insurance Act (S. 1177) proposes greater consumer protection, increased consumer information and choice, and increased competition among private insurers This amendment will not result in increased cost.Delivery system52
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WydenDPersonalized Medicine and Access to Critical Lab Tests Reduces Medicare spending and improves quality of care for amputees and persons with limb impairmentsDelivery system53
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WydenDTake Back Your Health Amendment To be determined when offered if needed.Delivery system54
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WydenDAuthorizing the use of new technologies that empower patients and their providers to get more value in accountable care organizations This amendment will not result in increased cost.Delivery system55
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WydenDTo encourage integrated care delivery across all care settings through integrated health clinics This amendment will not result in increased cost.Delivery system56
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WydenDGetting the best possible training for home health and other workers who provide hands-on care To be determined when offered if needed.Delivery system57
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WydenDRequiring the Medicare Payment Advisory Commission to consider Medicaid payments when making recommendations to Congress on Medicare Reimbursement for Skilled Nursing Facilities This amendment will not result in increased cost.Delivery system58
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WydenDEnsuring Quality Hospice Care To be determinedDelivery system59
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WydenDEnsuring Continuation of Benefits for seniors Covered Under Medicare Advantage To be determined.Delivery system60
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SchumerDAffordable Biosimilars Reimbursement Equity Amendment Savings to be applied towards improving affordability in the Exchange.Delivery system61
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SchumerDHHS Study regarding payment systems for new clinical laboratory diagnostic tests Delivery system62
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SchumerDHospital Reclassifications No cost anticipated.Delivery system63
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SchumerDChanges to Medicare DSH Reductions and Addition of Medicare DSH Report Delivery system64
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Schumer/ Menendez/BingamanD/D/DInclusion of Puerto Rico and the territories in the exchange Increase annual fee on for-profit health insurance providers by amount necessary to offset the increase in spendingCoverage65
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StabenowDTo provide technical guidance for the reimbursement of school-based health centers under Medicaid and the Children's Health Insurance Program Similar language was debated in the House Energy and commerce Committee and did not score.Delivery system66
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StabenowDTo authorize community mental health centers to obtain health information technology grants To the extent necessary, the fee on brand-name drug companies would be increased by $50 million across 5 yearsDelivery system67
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StabenowDTo authorize community mental health centers to obtain health information technology grants No additional funding would be allocated to this program.Delivery system68
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StabenowDTo provide training for advance practice nurses The brand-name pharmaceutical fee would be increased by $1 billion over ten years.Delivery system69
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StabenowDTo better integrate primary care and behavioral health services for our most vulnerable populations No offset is needed.Delivery system70
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StabenowDTo establish guidelines to ensure patient access for our nation's emergency rooms NoneDelivery system71
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StabenowDTo ensure access to our nation's emergency rooms and to encourage on-call specialists to serve our nation's emergency rooms - 5% Medicare bonus This amendment would be offset by an increase in the pharmaceutical fee on brand name drugs.Delivery system72
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StabenowDTo ensure access to our nation's emergency rooms and to encourage on-call specialists to serve our nation's emergency rooms - eliminate payment reduction for ER physicians This amendment would be offset by an increase in the pharmaceutical fee on brand name drugs.Delivery system73
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StabenowDTo establish a National Center on Hospital Quality. This amendment would be offset by an increase in the pharmaceutical fee on brand name drugs.Delivery system74
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StabenowDTo study barriers to appropriate utilization of generic medicine in our nation's Medicaid program NoneDelivery system75
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StabenowDTo give seniors enrolled in Medicare Part D plans more opportunities to sample affordable generic medicines This amendment is not expected to score.Delivery system76
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StabenowDTo ensure congressional intent is followed when the Centers for Medicare and Medicaid Services implement Section 508 This amendment would simply ensure that the existing block grant for Section 508 hospitals was being appropriately spent per congressional intent.Delivery system77
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StabenowDTo ensure congressional intent is followed when the Centers for Medicare and Medicaid Services implement Section 508 NoneDelivery system78
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StabenowDTo ensure patient access in Michigan's rural communities NoneDelivery system79
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Stabenow/ MenendezD/DRequires that the more than 13 million children enrolled I the CHIP in 2013 are not moved to the exchanges unless it is clear that they will secure coverage that it at least comparable or better to what they have in CHIP so that they are not left worse off by health reform To the extent necessary, the insurers' fee will be increasedCoverage80
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StabenowDTo correct a flaw in the Medicare Disproportionate Share formula that impacts the appropriate utilization of ventilation-dependent units This amendment is unlikely to affect a large number of hospitals and therefore trigger a CBO score. However, to the extent necessary to offset the amendment, the brand-name pharmaceutical fee would be increased an appropriate amount.Delivery system81
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StabenowDTo reclassify certain hospitals within Michigan To the extent necessary, the brand-name pharmaceutical fee would be increased an appropriate amount.Delivery system82
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Stabenow/ Wyden/KerryD/D/DTo ensure parity for mental health services within the exchange No offset neededCoverage83
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StabenowDTo protect our nation's seniors from abuse and assist nursing homes This amendment would be fully offset by mandating state use of National Correct Coding Initiative (NCCI) in Medicaid.Delivery system84
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StabenowDTo ensure the viability of certain hospitals The annual fee on manufacturers and importers of branded drugs would be increased an equivalent amount.Delivery system85
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CantwellDIncentivize Value in the Medicare Fee-For-Service Physician Payment Formula This amendment is budget neutral.Delivery system86
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CantwellDPhysician Workforce Enhancement The amendment specifies loan re-payment schedule making it budget neutral.Delivery system87
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Nelson/ RockefellerD/DEliminate the Part D Coverage Gap and Require Drug Maker Rebates for Full-Benefit Dual Eligible Individuals Require Part D Drug Rebates for Dual Eligible IndividualsDelivery system88
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NelsonDPrescription Drug Price Competition Amendment is expected to be budget neutral.Delivery system89
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NelsonDInspector General Report Comparing Prices Paid for Prescription Drugs under Medicare Part D and Medicaid Amendment is expected to be budget neutral.Delivery system90
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NelsonDMedicare Part D Copayment Equity Increase Medicaid drug rebate by amount necessary to offset the increase in spending.Delivery system91
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NelsonDMedicare Part D Copayment Equity (2) Increase Medicaid drug rebate by amount necessary to offset the increase in spending.Delivery system92
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Nelson/ Schumer/Cantwell/KerryD/D/D/DResident Physician Shortage Reduction Offset to be provided when amendment is offered.Delivery system93
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NelsonDMedicare Graduate Medical Education Slots Offset to be provided when amendment is offered.Delivery system94
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NelsonDGroup Purchasing Organization Sunshine Provision This amendment is expected to be budget neutral.Delivery system95
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NelsonDMedicare Physician Concierge Care Transparency This amendment is expected to be budget neutral.Delivery system96
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NelsonDMedicare Advantage Enrollee Benefit Stability This amendment would be offset by the creation of a Commission similar to the Medicare Commission included in the Chairman’s Mark to reduce costs and improve quality throughout the private health systemDelivery system97
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Menendez/ Kerry/Bingaman/ SchumerD/D/D/DMaking premiums more affordable Increase annual fee on health insurance providers by amount necessary to offset the increase in spendingCoverage98
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MenendezDDesignation of Urban Medicare-Dependent Hospitals (UMDH) No cost anticipatedDelivery system99
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