S.Amdt. 3240

SA 3240. Mr. ROCKEFELLER (for himself, Mr. Lieberman, Mr. Whitehouse,
and Mr. Bingaman) 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:

On page 1053, between lines 2 and 3, insert the following:

SEC. 3403A. IMPROVEMENTS TO THE INDEPENDENT MEDICARE ADVISORY
BOARD.

Section 1899A of the Social Security Act, as added by
section 3403, is amended--
(1) in subsection (c)--
(A) in paragraph (2)(A), by striking clause (iii) and
inserting the following new clause:
``(iii) As appropriate, the proposal may include
recommendations to adjust payments with respect to all
providers of services (as defined in section 1861(u)) and
suppliers (as defined in section 1861(d)).'';
(B) in paragraph (3)(A)(ii)--
(i) in subclause (I), by inserting ``or'' at the end;
(ii) in subclause (II), by striking ``; or'' at the end and
inserting a period; and
(iii) by striking subclause (III);
(C) in paragraph (7)(C), by striking clause (i) and
inserting the following new clause:
``(i) in the case of implementation year 2015 or any
subsequent implementation year, 1.5 percent; and''; and
(D) by striking paragraph (8);
(2) in subsection (e), by striking ``August 15'' each place
it appears and inserting ``June 1'';
(3) in subsection (f)(3)(B), by striking ``or advisory
reports to Congress'' and inserting ``, advisory reports, or
other reports'';
(4) by redesignating subsections (g) through (m) as
subsections (i) through (o), respectively; and
(5) by adding at the end the following new subsections:
``(g) Proposals in Non-Determination Years.--
``(1) In general.--In any proposal year in which the Board
is not required to transmit a proposal to the President by
reason of the application of subclause (I) or (II) of
subsection (c)(3)(A)(ii), the Board shall transmit a proposal
under this section to the President on January 15 of the
year. Except as provided in paragraph (2), such a proposal
shall be treated as a proposal under this section and all of
the provisions of this section with respect to proposals,
including the requirements under paragraphs (2) and (4) of
subsection (c) and the required Congressional consideration
under subsection (d), shall apply to the proposal.
``(2) Exceptions.--The following rules shall apply to a
proposal transmitted pursuant to paragraph (1):

[[Page S13274]]

``(A) Recommendations for achieving target.--The
requirement under subsection (c)(2)(A)(i) shall not apply.
``(B) Required information.--The proposal shall not
include--
``(i) recommendations described in subsection (c)(2)(A)(i),
pursuant to subsection (c)(3)(B)(i); or
``(ii) an actuarial opinion by the Chief Actuary of the
Centers for Medicare & Medicaid Services certifying that the
proposal meets the requirements of subsection (c)(2)(A)(i),
pursuant to subsection (c)(3)(B)(iii);
``(C) Contingent secretarial proposal.--The Secretary shall
not submit a proposal if the Board fails to submit a proposal
pursuant to subsection (c)(5).
``(D) Congressional consideration.--
``(i) Subparagraphs (A) and (B) of subsection (d)(3) shall
be applied by substituting `subsection (c)(2)(C)' for
`subparagraphs (A)(i) and (C) of subsection (c)(2)'.
``(ii) Subparagraphs (D) and (E) of subsection (d)(3) and
subsection (d)(4)(B)(v) shall be applied by requiring a
simple majority rather than three-fifths of the Members duly
chosen and sworn.
``(iii) Subsection (d)(4)(B)(iv) shall not apply.
``(iv) Subsection (d)(4)(C)(v)(II) shall be applied by
substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i)
and (C) of subsection (c)(2)'.
``(v) Subsection (d)(4)(E)(iv)(II) shall be applied by
substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i)
and (C) of subsection (c)(2)'.
``(E) Secretarial implementation.--Subsection (e) shall not
apply and the Secretary shall not implement the
recommendations contained in the proposal unless the
Secretary otherwise has the authority to implement such
recommendations.
``(h) Annual Report With Recommendations With Respect to
the Private Sector.--
``(1) In general.--Not later than July 1, 2014, and January
15, 2015, and annually thereafter, the Board shall submit to
Congress, the Secretary, and the Medicaid and CHIP Payment
and Access Commission a report that includes recommendations
on--
``(A) requirements under the program under this title (or
requirements included in the proposal submitted under this
section in the year); and
``(B) in the case of any report submitted in a year after a
determination year (beginning with determination year 2017)
in which the Chief Actuary of the Centers for Medicare &
Medicaid Services has made a determination described in
subclause (I) or (II) of subsection (c)(3)(A)(ii), other
requirements determined appropriate by the Board;

that should be included in the requirements established under
section 1311(c) of the Patient Protection and Affordable Care
Act for a health plan to be certified as a qualified health
plan, such as requirements that improve the health care
delivery system and health outcomes (including by promoting
integrated care, care coordination, prevention and wellness,
and quality and efficiency), decrease health care spending,
and other appropriate improvements
``(2) Incorporation into certification requirements.--
``(A) In general.--The Secretary shall review the
recommendations contained in the report submitted to the
Secretary by the Board under paragraph (1). The Secretary
may, if determined appropriate, incorporate such
recommendations into the requirements for certification under
such section 1311(c).
``(B) Report to congress.--Not later than December 31,
2014, and June 15, 2015, and annually thereafter, the
Secretary shall submit to Congress a report on the
application of subparagraph (A). Such report shall include,
with respect to each recommendation contained in a report
submitted by the Board in that year, a description of whether
or not the Secretary incorporated the recommendation into the
requirements for certification under such section 1311(c),
and if not, the reasons why.
``(3) MACPAC.--The Medicaid and CHIP Payment and Access
Commission shall--
``(A) review whether or not recommendations contained in a
report submitted to the Commission by the Board under
paragraph (1) would improve the Medicaid program under title
XIX and the Children's Health Insurance Program under title
XXI if implemented under such programs; and
``(B) include in the Commission's annual report to Congress
the results of such review.''.
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