Residential Recovery for Seniors Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The Residential Recovery for Seniors Act amends the Medicare program to cover certain residential substance use disorder services. Specifically, it expands Medicare coverage to include clinically managed low-intensity, clinically managed high-intensity, and medically managed residential substance use disorder services. These services must be provided by facilities meeting specific criteria and overseen by qualified professionals, with regular reviews of patient needs to ensure appropriate care. The bill also establishes a prospective payment system for these services, starting in 2026.
Key provisions
- Medicare coverage is expanded to include clinically managed low-intensity, clinically managed high-intensity, and medically managed residential substance use disorder services.
- Facilities providing these services must meet specific criteria, including accreditation and adherence to evidence-based treatment standards.
- Clinically managed facilities must regularly review patient needs and treatment plans.
- The bill defines key terms related to residential substance use disorder services, such as ‘clinically managed low-intensity’ and ‘clinically managed high-intensity’ facilities.
- A prospective payment system will be established for these services, beginning in 2026.
- The system will adjust payments based on the resource intensity of different service levels.
- Facilities must submit cost reports to the Secretary to support the development of the payment system.
- The initial payment rate in 2026 will be set at 100% of estimated reasonable costs.
Bill text
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