I 108th CONGRESS 2d Session H. R. 4304 IN THE HOUSE OF REPRESENTATIVES May 6, 2004 Mr. Boswell (for himself, Ms. Pelosi, Mr. Hoyer, Mr. Menendez, Mr. George Miller of California, Ms. DeLauro, Mr. Matsui, Mr. Rangel, Mr. Dingell, Mr. Berry, Mr. Brown of Ohio, Mr. Stark, Ms. Schakowsky, Mr. McDermott, Mr. Pallone, Mr. Green of Texas, Mr. Doggett, Mr. Allen, Mr. Sandlin, Ms. Solis, Mr. Frost, Mr. Serrano, Ms. Jackson-Lee of Texas, Mr. Grijalva, Mr. Hoeffel, Ms. Eshoo, Mr. Kildee, Mr. Weiner, Mr. Farr, Mr. Wexler, Mr. Hastings of Florida, Mr. Olver, Mr. Nadler, Mr. Hinchey, Mr. Tierney, Mr. Lantos, Mr. Moran of Virginia, Mrs. Maloney, Mr. Abercrombie, Ms. Kilpatrick, Mr. Clay, Mr. Kennedy of Rhode Island, Ms. Waters, Mr. Jackson of Illinois, Mr. Honda, Ms. Watson, Mr. Rodriguez, Mr. Gutierrez, Mr. Oberstar, Mrs. Lowey, Ms. Lofgren, and Ms. Slaughter) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and 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 the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to eliminate overpayments to health maintenance organizations and other private plans under part C of title XVIII of the Social Security Act.

1.

Short title

This Act may be cited as the &short-title1;.

2.

Elimination of ma regional plan stabilization fund (slush fund)

Subsection (e) of section 1858 of the Social Security Act, as added by section 221(c) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173), is repealed.

3.

Phase-in to payment at 100 percent of fee-for-service rate

Notwithstanding any other provision of law, the Secretary of Health and Human Services shall provide, beginning with 2005, for adjustment of payment rates to organizations under section 1853 of the Social Security Act so that such payment rates reflect only the payment rate described in subsection (c)(1)(D) of such section (relating to 100 percent fee-for-service payment).

4.

Application of risk adjustment reflecting characteristics for the entire medicare population

Notwithstanding any other provision of law, effective January 1, 2005, in applying risk adjustment factors to payment to organizations under section 1853 of the Social Security Act (42 U.S.C. 1395w–23) in a budget neutral manner, the Secretary of Health and Human Services shall assure that such factors, in the aggregate, take into account the actuarial characteristics of the entire medicare population, and not merely the population of individuals enrolled under a plan under part C of title XVIII of such Act.