HR 3467

This bill, HR 3467, proposes significant changes to the Medicare Advantage program. It mandates that Medicare Advantage plans pay for covered benefits on a capitated basis, reduces the blended benchmark used for payment calculations, and alters risk adjustment methodologies to focus on diagnoses from recent visits. The bill also introduces stop-loss payments for plans with unexpectedly high costs and establishes automatic enrollment of beneficiaries into the lowest-premium Medicare Advantage plan, with a three-year enrollment restriction. Finally, it requires Medicare Advantage plans to include hospice care in their offerings.