text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Preserving Medicare Advantage for 
  all Medicare Beneficiaries Act of 2015''.
  
  SEC. 2. FINDINGS.
  
      Congress makes the following findings:
              (1) In the IMPACT Act of 2014 (Public Law 113-185), 
          Congress recognized the potential effects of socioeconomic 
          status and dual eligible populations on the Medicare Advantage 
          STARS rating system by requesting the Assistant Secretary of 
          Planning and Evaluation in the Department of Health and Human 
          Services undertake studies on this population and the Medicare 
          program.
              (2) Studies published in the past year have shown the need 
          for an interim policy until the comprehensive results of the 
          studies undertaken as part of the IMPACT Act of 2014 are 
          published. An adjustment for 2016 is necessary while Congress 
          continues to work to achieve an appropriate policy for a 
          temporary bridge until the results from the studies undertaken 
          by the Assistant Secretary of Planning and Evaluation in the 
          Department of Health and Human Services under such Act are 
          finalized.
  
  SEC. 3. DELAY IN AUTHORITY TO TERMINATE CONTRACTS FOR CERTAIN MEDICARE 
                ADVANTAGE PLANS FAILING TO ACHIEVE MINIMUM QUALITY 
                RATINGS.
  
      Section 1857(h) of the Social Security Act (42 U.S.C. 1395w-27(h)) 
  is amended by adding at the end the following new paragraph:
              ``(3) Delay in contract termination authority for certain 
          plans failing to achieve minimum quality rating.--
                      ``(A) In general.--Subject to subparagraph (B), the 
                  Secretary may not terminate a contract under this 
                  section with respect to the offering of an MA plan by a 
                  Medicare Advantage organization solely because the MA 
                  plan has failed to achieve a minimum quality rating 
                  under the 5-star rating system established under 
                  section 1853(o) during the period beginning on the date 
                  of the enactment of this paragraph and through the end 
                  of plan year 2018.
                      ``(B) Application only to plans receiving a quality 
                  rating of at least 2 stars.--Subparagraph (A) shall 
                  only apply with respect to a contract with respect to 
                  the offering of an MA plan that has a quality rating 
                  under section 1853(o)(4) of at least 2 stars for the 
                  most recent plan year.''.
  
  SEC. 4. DEMONSTRATION PROJECT TO DIRECT QUALITY IMPROVEMENT PROGRAMS TO 
                ADDRESS SOCIOECONOMIC STATUS DISPARITIES IN MEDICARE 
                ADVANTAGE PLANS.
  
      (a) Establishment.--
              (1) In general.--The Secretary of Health and Human Services 
          (in this section referred to as the ``Secretary'') shall 
          establish a demonstration project under this section to provide 
          funds to MA organizations offering one or more qualified MA 
          plans for use in developing or expanding programs or services 
          with respect to such plans that seek to improve health care 
          delivery and outcomes of care for enrollees with low 
          socioeconomic status.
              (2) Duration.--The demonstration project under this section 
          shall be conducted for a period of 1 year beginning in plan 
          year 2016.
      (b) Definitions.--In this section:
              (1) MA organization; ma plan.--The terms ``MA 
          organization'' and ``MA plan'' have the meaning given such 
          terms in subsections (a)(1) and (b)(1), respectively, of 
          section 1859 of the Social Security Act (42 U.S.C. 1395w-28).
              (2) Qualified ma plan.--
                      (A) The term ``qualified MA plan'' means an MA plan 
                  described in subparagraph (B) or (C).
                      (B) An MA plan is described in this subparagraph if 
                  the MA plan meets each of the following criteria:
                              (i) The plan has a quality rating under 
                          section 1853(o)(4) of the Social Security Act 
                          (42 U.S.C. 1395w-23(o)(4)) of at least 3.25 
                          stars but not more than 4 stars for the most 
                          recent plan year.
                              (ii) Not less than 45 percent of enrollees 
                          in the plan are one or both of the following:
                                      (I) Eligible for a low income 
                                  subsidy under section 1860D-14 of such 
                                  Act (42 U.S.C. 1395w-114).
                                      (II) Dually eligible for benefits 
                                  under the Medicare program under title 
                                  XVIII of such Act (42 U.S.C. 1395 et 
                                  seq.) and the Medicaid program under 
                                  title XIX of such Act (42 U.S.C. 1396 
                                  et seq.).
                      (C) An MA plan is described in this subparagraph if 
                  the MA plan meets each of the following criteria:
                              (i) The plan has a quality rating under 
                          section 1853(o)(4) of the Social Security Act 
                          (42 U.S.C. 1395w-23(o)(4)) of at least 3.0 
                          stars but not more than 4 stars for the most 
                          recent plan year.
                              (ii) Not less than 60 percent of enrollees 
                          in the plan are one or both of the following:
                                      (I) Eligible for a low income 
                                  subsidy under section 1860D-14 of such 
                                  Act (42 U.S.C. 1395w-114).
                                      (II) Dually eligible for benefits 
                                  under the Medicare program under title 
                                  XVIII of such Act (42 U.S.C. 1395 et 
                                  seq.) and the Medicaid program under 
                                  title XIX of such Act (42 U.S.C. 1396 
                                  et seq.).
      (c) Use of Funds.--
              (1) In general.--Subject to paragraph (2), funds received 
          under the demonstration project by an MA organization with 
          respect to a qualified MA plan shall be used under the Quality 
          Improvement Program of the organization under section 1852(e) 
          of the Social Security Act (42 U.S.C. 1395w-22(e)) to target 
          improvement by the qualified MA plan with respect to two or 
          more triple-weighted measures under the 5-star rating system 
          under section 1853(o)(4) of such Act (42 U.S.C. 1395w-
          23(o)(4)).
              (2) Focus on outcome measure.--
                      (A) In general.--Except as provided in subparagraph 
                  (B), at least one of the measures targeted under 
                  paragraph (1) shall be an outcome measure.
                      (B) Exception.--An MA organization may apply to the 
                  Secretary for an exception to subparagraph (A) in order 
                  to focus on only process measures under this 
                  subsection.
      (d) Inclusion in Annual Quality Improvement Program Report.--An MA 
  organization receiving funds under the demonstration project shall 
  include, as part of the annual report to the Secretary on the Quality 
  Improvement Program of the organization under such section 1852(e) for 
  each year of the demonstration project, with respect to each qualified 
  MA plan offered by the organization, the results of the targeting of 
  plan improvement on measures under subsection (c) during the preceding 
  year.
      (e) Funding.--
              (1) In general.--For purposes of carrying out the 
          demonstration project under this section, subject to paragraph 
          (2), the Secretary shall provide for the transfer from the 
          Federal Hospital Insurance Trust Fund under section 1817 of the 
          Social Security Act (42 U.S.C. 1395i) and the Federal 
          Supplementary Medical Insurance Trust Fund under section 1841 
          of such Act (42 U.S.C. 1395t), in such proportion as the 
          Secretary determines appropriate, of an amount equal to the 
          amount the Secretary determines is equal to the estimated total 
          savings to the Medicare program as a result of the 
          implementation of the amendment made by section 2 to the 
          Centers for Medicare & Medicaid Services Program Management 
          Account.
              (2) Administration.--The Secretary may retain up to 10 
          percent of the funds transferred under paragraph (1) to 
          administer the demonstration project under this section and the 
          remainder of such funds shall be distributed in accordance with 
          this section to MA organizations offering qualified MA plans 
          based on the enrollment in such plans of individuals described 
          in each of subclauses (I) and (II) of subsections (b)(2)(B)(ii) 
          and (b)(2)(C)(ii).
              (3) Availability.--Amounts transferred under paragraph (1) 
          shall remain available until expended.
target: Preserving Medicare Advantage for all Medicare Beneficiaries Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to: (1) temporarily prohibit the Centers for Medicare &amp; Medicaid from terminating a Medicare Advantage (MA) plan contract solely because the MA plan fails to achieve a certain minimum quality rating, provided that the MA plan achieves a quality rating of at least two out of five stars; and (2) establish a demonstration project to provide funds to MA organizations for the development or expansion of programs or services to improve health care delivery and outcomes for enrollees of low socioeconomic status. To qualify for demonstration project funding, an MA plan must meet specified requirements with respect to quality ratings and the percentage of plan enrollees either eligible for a low-income subsidy or dually eligible for Medicare and Medicaid. MA organizations receiving funds under the demonstration project must use those funds to target improvement by the MA plan with respect to certain quality rating measures.
feat_title: Preserving Medicare Advantage for all Medicare Beneficiaries Act of 2015