[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 590 Introduced in Senate (IS)]







108th CONGRESS
  1st Session
                                 S. 590

    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 SENATE OF THE UNITED STATES

                             March 11, 2003

  Mr. Schumer (for himself and Mr. Santorum) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 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+Choice Equity and Access 
Act of 2003''.

SEC. 2. OPTION TO RECEIVE PAYMENT BASED ON ADJUSTED AVERAGE PER CAPITA 
              COST.

    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, in the case of payments for 
        months beginning on or after January 1, 2004, (D)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(D) Based on 100 percent of fee-for-service 
                costs.--The adjusted average per capita cost for the 
                year involved, determined under section 1876(a)(4) for 
                the Medicare+Choice payment area for services covered 
                under parts A and B for individuals entitled to 
                benefits under part A and enrolled under part B who are 
                not enrolled in a Medicare+Choice plan under this part 
                for the year, but adjusted to exclude costs 
                attributable to payments under section 1886(h).''.

SEC. 3. REVISION OF FORMULA USED TO CALCULATE THE NATIONAL STANDARDIZED 
              ANNUAL MEDICARE+CHOICE CAPITATION RATE TO REFLECT 
              MEDICARE+CHOICE ENROLLMENT.

    Section 1853(c)(4)(B)(i)(II) of the Social Security Act (42 U.S.C. 
1395w-23(c)(4)(B)(i)(II)) is amended by inserting ``(or, in the case of 
calculations for payments for months beginning on or after January 1, 
2004, the average number of medicare beneficiaries enrolled in a 
Medicare+Choice plan that are)'' after ``medicare beneficiaries''.

SEC. 4. REMOVAL OF APPLICATION OF BUDGET NEUTRALITY TO BLENDED 
              CAPITATION RATE.

    Section 1853(c) of the Social Security Act (42 U.S.C. 1395w-23(c)) 
is amended--
            (1) in paragraph (1)(A), in the matter following clause 
        (ii), by inserting ``(for years before 2004)'' after 
        ``multiplied''; and
            (2) in paragraph (5), by inserting ``(before 2004)'' after 
        ``for each year''.

SEC. 5. INCREASE OF THE MINIMUM PERCENTAGE INCREASE.

    Section 1853(c)(1)(C) of the Social Security Act (42 U.S.C. 1395w-
23(c)(1)(C)) is amended by striking clause (iv) and inserting the 
following:
                            ``(iv) For 2002 and 2003, 102 percent of 
                        the annual Medicare+Choice capitation rate 
                        under this paragraph for the area for the 
                        previous year.
                            ``(v) For 2004 and each succeeding year, 
                        104 percent of the annual Medicare+Choice 
                        capitation rate under this paragraph for the 
                        area for the previous year.''.
                                 <all>