[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4968 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4968

    To amend title XVIII of the Social Security Act to provide for 
      equitable reimbursement rates under the Medicare Program to 
                     Medicare+Choice organizations.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 26, 2000

 Ms. Dunn (for herself, Mr. Kleczka, and Mr. McDermott) 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 title XVIII of the Social Security Act to provide for 
      equitable reimbursement rates under the Medicare Program to 
                     Medicare+Choice 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 ``Medicare Equity and Access Act of 
2000''.

SEC. 2. ELIMINATION OF REDUCTION IN MEDICARE+CHOICE PAYMENT RATES BY 
              BUDGET NEUTRALITY ADJUSTMENTS.

    (a) In General.--Section 1853(c)(1)(A) of the Social Security Act 
(42 U.S.C. 1395w-23(c)(1)(A)) is amended by adding at the end the 
following: ``With respect to years beginning on or after January 1, 
2001, in no case shall the budget neutrality adjustment provided for in 
the previous sentence result in a reduction of the payment amount that 
would otherwise be made under this subparagraph but for such 
adjustment.''.
    (b) Transitional Rule in 2000 for Submission of Required 
Information.--Notwithstanding section 1854(a)(1) of the Social Security 
Act (42 U.S.C. 1395w-24(a)(1)), the deadline for a Medicare+Choice 
organization offering of a Medicare+Choice plan under part C of title 
XVIII of the Social Security Act to submit information, including the 
adjusted community rate (as defined in subsection (f)(3) of that 
section), required for the offering of such a plan for 2001 is delayed 
from July 1, 2000, to December 1, 2000.

SEC. 3. ACCELERATION OF MOVEMENT TO 50:50 PERCENT BLEND IN 2001.

    Section 1853(c)(2) of the Social Security Act (42 U.S.C. 1395w-
23(c)(2)) is amended--
            (1) by adding ``and'' at the end of subparagraph (C);
            (2) by striking subparagraphs (D) and (E);
            (3) by redesignating subparagraph (F) as subparagraph (D); 
        and
            (4) in subparagraph (D), as so redesignated, by striking 
        ``2002'' and inserting ``2000''.

SEC. 4. INCREASE IN BASELINE OF NATIONAL PER CAPITA MEDICARE+CHOICE 
              GROWTH PERCENTAGE FOR YEARS AFTER 2000.

    (a) In General.--Section 1853(c)(6)(B) of the Social Security Act 
(42 U.S.C. 1395w-23(c)(6)(B)) is amended--
            (1) in clause (i), by striking ``0.8 percentage points'' 
        and inserting ``0 percentage points''; and
            (2) in clause (ii), by striking ``0.5 percentage points'' 
        and inserting ``0 percentage points''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to payment rates calculated for months beginning on 
or after January 1, 2001.

SEC. 5. INCLUSION OF COSTS OF DOD MILITARY TREATMENT FACILITY SERVICES 
              TO MEDICARE-ELIGIBLE BENEFICIARIES IN CALCULATION OF 
              MEDICARE+CHOICE PAYMENT RATES.

    Section 1853(c)(3) of the Social Security Act (42 U.S.C. 1395w-
23(c)(3)) is amended--
            (1) in subparagraph (A), by striking ``subparagraph (B)'' 
        and inserting ``subparagraphs (B) and (E)'', and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Inclusion of costs of certain dod military 
                treatment facility services to medicare-eligible 
                beneficiaries.--
                            ``(i) In general.--In determining the area-
                        specific Medicare+Choice capitation rate under 
                        subparagraph (A) for a year (beginning with 
                        2001), the annual per capita rate of payment 
                        for 1997 determined under section 1876(a)(1)(C) 
                        for a Medicare+Choice payment area that is 
                        within one or more MTF affected areas (as 
                        defined in clause (ii)) shall be increased by 
                        the sum of the MTF percentages (as described in 
                        clause (iii)) for the MTF affected area or 
                        areas. The increase under this subparagraph 
                        shall not be taken into account in computing 
                        the national standardized annual 
                        Medicare+Choice capitation rate under paragraph 
                        (4)(B).
                            ``(ii) MTF affected area defined.--In this 
                        subparagraph, the term `MTF affected area' 
                        means, with respect to a military treatment 
                        facility (as defined in subsection (a)(6) of 
                        section 1896), an area that includes the 
                        following:
                                    ``(I) The Medicare+Choice payment 
                                area in which a military treatment 
                                facility is located.
                                    ``(II) Any Medicare+Choice payment 
                                area which is contiguous to the area 
                                described in subclause (I) and located 
                                not farther than 40 miles from the 
                                facility.
                            ``(iii) MTF percentage.--For purposes of 
                        clause (i), the MTF percentage for an MTF 
                        affected area is equal to the ratio of--
                                    ``(I) the aggregate amount of costs 
                                incurred by the Department of Defense 
                                in furnishing items and services to 
                                individuals entitled to benefits under 
                                this title who received services from 
                                the military treatment facility 
                                described in clause (ii) for that area 
                                in 1996 (as determined pursuant to 
                                section 1896(j)(1)(A)), increased by 
                                the national per capita Medicare+Choice 
                                growth percentage under paragraph (6) 
                                for 1997, to
                                    ``(II) the average number of 
                                individuals residing in such area in 
                                1996 entitled to benefits under part A 
                                and enrolled under part B.''.
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