[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3284 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 3284

 To amend part C of title XVIII to provide for an improved methodology 
         for the calculation of Medicare+Choice payment rates.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 9, 1999

 Mr. Pallone introduced the following bill; which was referred to the 
   Committee on Ways and Means, and in addition to the Committee on 
Commerce, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To amend part C of title XVIII to provide for an improved methodology 
         for the calculation of Medicare+Choice payment rates.

    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 ``Medicare Beneficiaries' Choice 
Protection Act of 1999''.

SEC. 2. ESTABLISHMENT OF PAYMENT FLOOR FOR MEDICARE+CHOICE PAYMENT 
              RATES AFTER APPLYING RISK-ADJUSTMENT METHODOLOGY.

    (a) In General.--Section 1853(c)(1) of the Social Security Act (42 
U.S.C. 1395w-23(c)(1)) is amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``or (C)'' and inserting ``(C), or (D)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(D) Demographically adjusted fee-for-service per 
                capita expenditures.--
                            ``(i) In general.--For 2001 and each 
                        subsequent year, 94 percent of the adjusted 
                        average per capita cost for the year for the 
                        Medicare+Choice payment area determined by the 
                        Secretary based upon the rule specified under 
                        paragraph (4) of section 1876(a) and calculated 
                        without regard to the adjustment under 
                        paragraph (1)(C) of such section.
                            ``(ii) Special rule for risk adjustment.--
                        For purposes of applying risk adjustment to the 
                        payment amount determined under this 
                        subparagraph for a demographic class, the risk 
                        adjustment for such demographic class shall be 
                        determined under the methodology applied by the 
                        Secretary under section 1876(a)(4) without 
                        regard to subsection (a)(3) of this section.''.
    (b) Continuation of Computation of AAPCC Data.--Section 1853(b) of 
such Act (42 U.S.C. 1395w-23(b)) is amended by adding at the end the 
following new paragraph:
            ``(4) Continued computation and publication of county-
        specific per capita fee-for-service expenditure information.--
        Using the most recent data available, the Secretary shall 
        provide for the computation and publication, on an annual basis 
        at the time of publication of the annual Medicare+Choice 
        capitation rates, of information on the level of the average 
        annual per capita costs (described in section 1876(a)(4)) for 
        each Medicare+Choice payment area.''.
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