To make improvements in the MedicareAdvantage benchmark determinations.
What it does: Adds SEC. ____. IMPROVEMENTS IN MEDICAREADVANTAGE BENCHMARK DETERMINATIONS at the end of subtitle A of title IIWhat it changes
1 change to S. 1 · shown in the bill's text
Adds SEC. ____. IMPROVEMENTS IN MEDICAREADVANTAGE BENCHMARK DETERMINATIONS at the end of subtitle A of title II
Adds a sectionIn S. 1 · Reported to Senate
(b) MedicareAdvantage MSA Plans.--Notwithstanding any provision of this title, the Secretary shall apply the payment and other rules that apply with respect to an MSA plan described in section 1851(a)(2)(B) of the Social Security Act (42 U.S.C. 1395w-21(a)(2)(B)) as if this title had not been enacted.
Inserted: SEC. ____. IMPROVEMENTS IN MEDICAREADVANTAGE BENCHMARK DETERMINATIONS.
Inserted: (a) Revision of National Average Used in Calculation of Blend.--Section 1853(c)(4)(B)(i)(II) (42 U.S.C. 1395w-23(c)(4)(B)(i)(II)), as amended by section 203, is amended by inserting "who are enrolled in a MedicareAdvantage plan" after "the average number of medicare beneficiaries".
Inserted: (b) Change in Budget Neutrality.--Section 1853(c) (42 U.S.C. 1395w-23(c)), as amended by section 203, is amended--
Inserted: (1) in paragraph (1)(A)--
Inserted: (A) in clause (ii), by striking the comma at the end and inserting a period; and
Inserted: (B) by striking the flush matter following clause (ii); and
Inserted: (2) by striking paragraph (5).
Inserted: (c) Inclusion of Costs of DOD and VA Military Facility Services to Medicare-eligible Beneficiaries in Calculation of Medicare+Choice Payment Rates.--
Inserted: (1) For purposes of calculating medicare+choice payment rates.--Section 1853(c)(3) (42 U.S.C. 1395w-23(c)(3)), as amended by section 203, is amended--
Inserted: (A) in subparagraph (A), by striking "subparagraph (B)" and inserting "subparagraphs (B) and (E)"; and
Inserted: (B) by adding at the end the following new subparagraph:
Inserted: "(E) Inclusion of costs of dod and va military facility services to medicare-eligible beneficiaries.--In determining the area-specific Medicare+Choice capitation rate under subparagraph (A) for a year (beginning with 2006), the annual per capita rate of payment for 1997 determined under section 1876(a)(1)(C) shall be adjusted to include in the rate the Secretary's estimate, on a per capita basis, of the amount of additional payments that would have been made in the area involved under this title if individuals entitled to benefits under this title had not received services from facilities of the Department of Defense or the Department of Veterans Affairs.".
Show 5 more inserted paragraphsShow less
Inserted: (2) For purposes of calculating local fee-for-service rates.--Section 1853(d)(5) (42 U.S.C. 1395w-23(d)(5)), as amended by section 203, is amended--
Inserted: (A) in subparagraph (A), by striking "subparagraph (B)" and inserting "subparagraphs (B) and (C)"; and
Inserted: (B) by adding at the end the following new subparagraph:
Inserted: "(C) Inclusion of costs of dod and va military facility services to medicare-eligible beneficiaries.--In determining the local fee-for-service rate under subparagraph (A) for a year (beginning with 2006), the annual per capita rate of payment for 1997 determined under section 1876(a)(1)(C) shall be adjusted to include in the rate the Secretary's estimate, on a per capita basis, of the amount of additional payments that would have been made in the area involved under this title if individuals entitled to benefits under this title had not received services from facilities of the Department of Defense or the Department of Veterans Affairs.".
Inserted: (d) Effective Date.--The amendments made by this section shall apply with respect to plan years beginning on and after January 1, 2006.
Original wording
At the end of subtitle A of title II, add the following:
Read automatically from the Congressional Record. Check the original before relying on it.
As printed
SA 961. Mrs. MURRAY submitted an amendment intended to be proposed by her to the bill S. 1, to amend title XVIII of the Social Security Act to make improvements in the medicare program, to provide prescription drug coverage under the medicare program, and for other purposes; which was ordered to lie on the table; as follows:
At the end of subtitle A of title II, add the following:
SEC. ____. IMPROVEMENTS IN MEDICAREADVANTAGE BENCHMARK DETERMINATIONS.
(a) Revision of National Average Used in Calculation of Blend.--Section 1853(c)(4)(B)(i)(II) (42 U.S.C. 1395w-23(c)(4)(B)(i)(II)), as amended by section 203, is amended by inserting “who are enrolled in a MedicareAdvantage plan” after “the average number of medicare beneficiaries”.
(b) Change in Budget Neutrality.--Section 1853(c) (42 U.S.C. 1395w-23(c)), as amended by section 203, is amended--
(1) in paragraph (1)(A)--
(A) in clause (ii), by striking the comma at the end and inserting a period; and
(B) by striking the flush matter following clause (ii); and
(2) by striking paragraph (5).
(c) Inclusion of Costs of DOD and VA Military Facility Services to Medicare-eligible Beneficiaries in Calculation of Medicare+Choice Payment Rates.--
(1) For purposes of calculating medicare+choice payment rates.--Section 1853(c)(3) (42 U.S.C. 1395w-23(c)(3)), as amended by section 203, is amended--
(A) in subparagraph (A), by striking “subparagraph (B)” and inserting “subparagraphs (B) and (E)”; and
(B) by adding at the end the following new subparagraph:
“(E) Inclusion of costs of dod and va military facility services to medicare-eligible beneficiaries.--In determining the area-specific Medicare+Choice capitation rate under subparagraph (A) for a year (beginning with 2006), the annual per capita rate of payment for 1997 determined under section 1876(a)(1)(C) shall be adjusted to include in the rate the Secretary's estimate, on a per capita basis, of the amount of additional payments that would have been made in the area involved under this title if individuals entitled to benefits under this title had not received services from facilities of the Department of Defense or the Department of Veterans Affairs.”.
(2) For purposes of calculating local fee-for-service rates.--Section 1853(d)(5) (42 U.S.C. 1395w-23(d)(5)), as amended by section 203, is amended--
(A) in subparagraph (A), by striking “subparagraph (B)” and inserting “subparagraphs (B) and (C)”; and
(B) by adding at the end the following new subparagraph:
“(C) Inclusion of costs of dod and va military facility services to medicare-eligible beneficiaries.--In determining the local fee-for-service rate under subparagraph (A) for a year (beginning with 2006), the annual per capita rate of payment for 1997 determined under section 1876(a)(1)(C) shall be adjusted to include in the rate the Secretary's estimate, on a per capita basis, of the amount of additional payments that would have been made in the area involved under this title if individuals entitled to benefits under this title had not received services from facilities of the Department of Defense or the Department of Veterans Affairs.”.
(d) Effective Date.--The amendments made by this section shall apply with respect to plan years beginning on and after January 1, 2006.
Legislative Activity
Stay on top of the latest movement without scrolling through every action
Amendment SA 961, previously agreed to, was modified by Unanimous Consent.
June 26, 2003
View full timeline
Amendment SA 961, previously agreed to, was modified by Unanimous Consent.
June 26, 2003
Senate amendment proposed (on the floor): Amendment SA 961 proposed by Senator Grassley for Senator Murray.(consideration: CR S8538; text: CR S8538)
June 25, 2003
Senate amendment agreed to: Amendment SA 961 agreed to in Senate by Voice Vote.
June 25, 2003
Amendment SA 961 proposed by Senator Grassley for Senator Murray. (consideration: CR S8538; text: CR S8538) To make improvements in the MedicareAdvantage benchmark determinations.
June 25, 2003
Amendment SA 961 agreed to in Senate by Voice Vote.
June 25, 2003
Senate amendment submitted
June 20, 2003