[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2906 Introduced in Senate (IS)]
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108th CONGRESS
2d Session
S. 2906
To amend title XVIII of the Social Security Act to provide for
reductions in the medicare part B premium through elimination of
certain overpayments to Medicare Advantage organizations.
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IN THE SENATE OF THE UNITED STATES
October 6, 2004
Mr. Bingaman (for himself, Ms. Mikulski, Mr. Graham of Florida, Mr.
Corzine, Mr. Harkin, Mr. Durbin, Mr. Feingold, Mr. Rockefeller, and Mr.
Kohl) introduced the following bill; which was read twice and referred
to the Committee on Finance
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A BILL
To amend title XVIII of the Social Security Act to provide for
reductions in the medicare part B premium through elimination of
certain overpayments to Medicare Advantage organizations.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Affordability in Medicare Premiums
Act of 2004''.
SEC. 2. REDUCTION OF MEDICARE PART B PREMIUM FOR INDIVIDUALS NOT
ENROLLED IN A MEDICARE ADVANTAGE PLAN.
Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)) is
amended--
(1) in paragraph (3), in the first sentence, by striking
``The Secretary'' and inserting ``Subject to paragraph (5), the
Secretary''; and
(2) by adding at the end the following new paragraph:
``(5)(A) For each year (beginning with 2005), the Secretary shall
reduce the monthly premium rate determined under paragraph (3) for each
month in the year for individuals who are not enrolled in a Medicare
Advantage plan (including such individuals subject to an increased
premium under subsection (b) or (i)) so that the aggregate amount of
such reductions in the year is equal to the aggregate amount of reduced
expenditures from the Federal Supplementary Medicare Insurance Trust
Fund that the Secretary estimates would result in the year if the
annual Medicare+Choice capitation rate for the year was equal to the
amount specified under subparagraph (D) of section 1853(c)(1), and not
subparagraph (A), (B), or (C) of such section.
``(B) In order to carry out subsections (a)(1) and (b)(1) of
section 1840, the Secretary shall transmit to the Commissioner of
Social Security and the Railroad Retirement Board by the beginning of
each year (beginning with 2005), such information determined
appropriate by the Secretary, in consultation with the Commissioner of
Social Security and the Railroad Retirement Board, regarding the amount
of the monthly premium rate determined under paragraph (3) for
individuals after the application of subparagraph (A).''.
SEC. 3. FUNDING REDUCTIONS IN THE MEDICARE PART B PREMIUM THROUGH
REDUCTIONS IN PAYMENTS TO MEDICARE ADVANTAGE
ORGANIZATIONS.
Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)), as
amended by section 2, is amended--
(1) in paragraph (3), in the first sentence, by striking
``paragraph (5)'' and inserting ``paragraphs (5) and (6)''; and
(2) by adding at the end the following new paragraph:
``(6) For each year (beginning with 2005), the Secretary shall
reduce the monthly premium rate determined under paragraph (3) for each
month in the year for each individual enrolled under this part
(including such an individual subject to an increased premium under
subsection (b) or (i)) so that the aggregate amount of such reductions
in the year is equal to an amount equal to--
``(A) the aggregate amount of reduced expenditures from the
Federal Supplementary Medicare Insurance Trust Fund in the year
that the Secretary estimates will result from the provisions
of, and the amendments made by, sections 4 and 5 of the
Affordability in Medicare Premiums Act of 2004; minus
``(B) the aggregate amount of reductions in the monthly
premium rate in the year pursuant to paragraph (5)(A).''.
SEC. 4. APPLICATION OF RISK ADJUSTMENT REFLECTING CHARACTERISTICS FOR
THE ENTIRE MEDICARE POPULATION IN PAYMENTS TO MEDICARE
ADVANTAGE ORGANIZATIONS.
Effective January 1, 2005, in applying risk adjustment factors to
payments to organizations under section 1853 of the Social Security Act
(42 U.S.C. 1395w-23), the Secretary of Health and Human Services shall
ensure that payments to such organizations are adjusted based on such
factors to ensure that the health status of the enrollee is reflected
in such adjusted payments, including adjusting for the difference
between the health status of the enrollee and individuals enrolled
under the original medicare fee-for-service program under parts A and B
of title XVIII of such Act. Payments to such organizations must, in
aggregate, reflect such differences.
SEC. 5. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND (SLUSH
FUND).
Subsection (e) of section 1858 of the Social Security Act (42
U.S.C. 1395w-27a), as added by section 221(c) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (Public
Law 108-173), is repealed.
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