Gus Bilirakis Introduces the Addressing Social Determinants in Medicare Advantage Act

Last week, U.S. Rep. Gus Bilirakis, R-Fla., introduced the “Addressing Social Determinants in Medicare Advantage Act.”

The congressman’s office offered some of the rationales behind his proposal after he brought it out, noting the bill “encourages Medicare Advantage programs to offer supplemental benefits to address social determinants of health.”

“There is growing recognition in the field of public health that reducing long-standing disparities in health outcomes is dependent on systemically addressing the social, economic, and environmental factors that influence overall health and wellness. Examples of social determinants of health include: socioeconomic status, education, physical environment, employment, social support networks, and access to healthcare. Under current law, Medicare Advantage plans are permitted to offer a wide array of supplemental benefits to chronically ill enrollees. These expanded benefits are required to have a reasonable expectation of improving or maintaining patient health. The new Bilirakis bill allows Medicare Advantage plans the same flexibility to provide targeted supplemental benefits to low-income patients and other beneficiaries who are at high risk for developing chronic conditions or experiencing poorer health outcomes due to factors related to social determinants of health,” the congressman’s office noted.

“This commonsense legislation employs the basic principles of hierarchical needs. We must look at the big picture. It is impossible to improve the population health of communities without addressing the factors that contribute to poor health outcomes. Prevention, education, and improving access are essential components of effective public health programs. Allowing Medicare Advantage programs to target supplemental programs based upon these factors can help to improve patient outcomes for high risk seniors. This is not just a pragmatic approach, it is the right thing to do as we work to ensure all seniors receive the best possible care,” said Bilirakis.

The bill was sent to the U.S. House Ways and Means and the Energy and Commerce Committees last week. So far, there is no companion measure over in the U.S. Senate and Bilirakis has not reeled in any co-sponsors.


Reach Kevin Derby at


Kevin Derby
Share this story on Facebook or Twitter or Send in a Text Message::