[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2300 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2300

To amend the Medicare Prescription Drug, Improvement, and Modernization 
 Act of 2003 to eliminate privatization of the medicare program and to 
reduce excessive payments to health maintenance organizations and other 
                    private sector insurance plans.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 7, 2004

  Mr. Kennedy (for himself, Mr. Bingaman, Mrs. Boxer, Mr. Pryor, Mr. 
 Hollings, Mr. Corzine, Mr. Edwards, Ms. Mikulski, Mr. Lautenberg, Mr. 
Durbin, and Ms. Stabenow) introduced the following bill; which was read 
             twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend the Medicare Prescription Drug, Improvement, and Modernization 
 Act of 2003 to eliminate privatization of the medicare program and to 
reduce excessive payments to health maintenance organizations and other 
                    private sector insurance plans.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Defense of 
Medicare Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Application of risk adjustment reflecting characteristics for 
                            the entire medicare population in payments 
                            to Medicare Advantage organizations.
Sec. 3. Annual Medicare Advantage capitation rate at 100 percent of 
                            fee-for-service rate with a hold harmless.
Sec. 4. Elimination of MA Regional Plan Stabilization Fund (slush 
                            fund).
Sec. 5. Repeal of premium support program.
Sec. 6. Requiring two prescription drug plans to avoid Federal 
                            fallback.

SEC. 2. 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. 3. ANNUAL MEDICARE ADVANTAGE CAPITATION RATE AT 100 PERCENT OF 
              FEE-FOR-SERVICE RATE WITH A HOLD HARMLESS.

    Section 1853(c)(1) of the Social Security Act (42 U.S.C. 1395w-
23(c)(1)), as amended by section 211 of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 
Stat. 2176) is amended--
            (1) in subparagraph (B), by adding at the end the following 
        new clause:
                            ``(v) For 2005 and each subsequent year, 
                        the amount specified in clause (iv) for the 
                        area for 2004.''; and
            (2) in subparagraph (C)(v), in the matter preceding 
        subclause (I), by striking ``and each succeeding year''.

SEC. 4. 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.

SEC. 5. REPEAL OF PREMIUM SUPPORT PROGRAM.

    Effective as if included in the enactment of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (Public 
Law 108-173), subtitle E of title II of such Act is repealed and any 
provisions of law amended by such subtitle are restored as if such 
subtitle had not been enacted.

SEC. 6. REQUIRING TWO PRESCRIPTION DRUG PLANS TO AVOID FEDERAL 
              FALLBACK.

    Section 1860D-3(a) of the Social Security Act, as added by section 
101(a) of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003, is amended--
            (1) in paragraph (1)--
                    (A) by striking ``qualifying plans (as defined in 
                paragraph (3))'' and inserting ``prescription drug 
                plans''; and
                    (B) by striking ``, at least one of which is a 
                prescription drug plan'';
            (2) in paragraph (2), by striking ``qualifying plans'' and 
        inserting ``prescription drug plans''; and
            (3) by striking paragraph (3).
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