S.Amdt. 2886

SA 2886. Mr. FEINGOLD (for himself, Ms. Klobuchar, Mr. Kohl, and Mr.
Wyden) submitted an amendment intended to be proposed to amendment SA
2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr.
Harkin) to the bill H.R. 3590, to amend the Internal Revenue Code of
1986 to modify the first-time homebuyers credit in the case of members
of the Armed Forces and certain other Federal employees, and for other
purposes; which was ordered to lie on the table; as follows:

Beginning on page 751, between lines 2 and 3, insert the
following:

SEC. 3022A. IMPROVEMENTS IN THE MEDICARE SHARED SAVINGS
PROGRAM.

(a) In General.--Section 1899 of the Social Security Act,
as added by section 3022, is amended--
(1) in subsection (b)--
(A) in paragraph (1)(D), by inserting ``or critical access
hospitals'' before the period at the end; and
(B) in paragraph (2), by adding at the end the following
new subparagraph:
``(I) The ACO shall take into account the special needs of
hospitals located in rural areas.''; and
(2) by striking subsection (d)(1)(B)(ii) and inserting the
following new clause:
``(ii) Establish and update benchmark.--The Secretary shall
estimate a benchmark for each agreement period for each ACO
that is based--

``(I) 50 percent on the most recent available 3 years of
per-beneficiary expenditures for parts A and B services for
Medicare fee-for-service beneficiaries assigned to the ACO;
and
``(II) 50 percent on the national average of the most
recent available 3 years of per-beneficiary expenditures for
parts A and B services for Medicare fee-for-service
beneficiaries.

Such benchmark shall be adjusted for beneficiary
characteristics and such other factors as the Secretary
determines appropriate and updated by the projected absolute
amount of growth in national per capita expenditures for
parts A and B services under the original Medicare fee-for-
service program, as estimated by the Secretary. Such
benchmark shall be reset at the start of each agreement
period. In establishing the benchmarks under this clause, the
Secretary implements the amendment made by section 3022A(2)
in a budget-neutral manner.''.
(b) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study on the applicability of Accountable
Care Organizations (ACOs) in rural, frontier areas. Such
study shall include an analysis of--
(A) ways to demonstrate that Accountable Care Organizations
or similar models might successfully form in rural, frontier
areas in order to ensure that under-populated areas are able
to benefit from the shared savings and care coordination
offered by Accountable Care Organizations; and
(B) other areas determined appropriate by the Secretary.
(2) Report.--Not later than January 1, 2011, the
Comptroller General of the United States shall submit to
Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations
for such legislation and administrative action as the
Comptroller General determines appropriate.
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