Summary
Beginning in 2010, makes this demonstration program permanent and allows these plans to limit their services to the geographic area in which the housing facility is located.
Implementation Status
On April 15, 2011, CMS published a Final Rule implementing several provisions of the ACA, including this section (see pp. 21448-51).
Statutory Text
SEC. 3208. MAKING SENIOR HOUSING FACILITY DEMONSTRATION PERMANENT. (a) IN GENERAL.—Section 1859 of the Social Security Act (42 U.S.C. 1395w–28) is amended by adding at the end the following new subsection: ‘‘(g) SPECIAL RULES FOR SENIOR HOUSING FACILITY PLANS.— ‘‘(1) IN GENERAL.—In the case of a Medicare Advantage senior housing facility plan described in paragraph (2), notwithstanding any other provision of this part to the contrary and in accordance with regulations of the Secretary, the service area of such plan may be limited to a senior housing facility in a geographic area. ‘‘(2) MEDICARE ADVANTAGE SENIOR HOUSING FACILITY PLAN DESCRIBED.—For purposes of this subsection, a Medicare Advantage senior housing facility plan is a Medicare Advantage plan that— ‘‘(A) restricts enrollment of individuals under this part to individuals who reside in a continuing care retirement community (as defined in section 1852(l)(4)(B)); ‘‘(B) provides primary care services onsite and has a ratio of accessible physicians to beneficiaries that the Secretary determines is adequate; ‘‘(C) provides transportation services for beneficiaries to specialty providers outside of the facility; and ‘‘(D) has participated (as of December 31, 2009) in a demonstration project established by the Secretary under which such a plan was offered for not less than 1 year.’’. (b) EFFECTIVE DATE.—The amendment made by this section shall take effect on January 1, 2010, and shall apply to plan years beginning on or after such date.