[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1589 Introduced in Senate (IS)]








109th CONGRESS
  1st Session
                                S. 1589

    To amend title XVIII of the Social Security Act to provide for 
   reductions in the medicare part B premium through elimination of 
       certain overpayments to Medicare Advantage organizations.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 29, 2005

Mr. Bingaman (for himself, Mr. Rockefeller, Mr. Feingold, Mr. Corzine, 
  Mr. Kohl, Ms. Mikulski, Mr. Durbin, and Mr. Harkin) 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 
   reductions in the medicare part B premium through elimination of 
       certain overpayments to Medicare Advantage 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 ``Affordability in Medicare Premiums 
Act of 2005''.

SEC. 2. REDUCTION OF MEDICARE PART B PREMIUM FOR INDIVIDUALS NOT 
              ENROLLED IN A MEDICARE ADVANTAGE PLAN.

    Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)) is 
amended--
            (1) in paragraph (3), in the first sentence, by striking 
        ``The Secretary'' and inserting ``Subject to paragraph (5), the 
        Secretary''; and
            (2) by adding at the end the following new paragraph:
    ``(5)(A) For each year (beginning with 2006), the Secretary shall 
reduce the monthly premium rate determined under paragraph (3) for each 
month in the year for individuals who are not enrolled in a Medicare 
Advantage plan (including such individuals subject to an increased 
premium under subsection (b) or (i)) so that the aggregate amount of 
such reductions in the year is equal to the aggregate amount of reduced 
expenditures from the Federal Supplementary Medicare Insurance Trust 
Fund that the Secretary estimates would result in the year if the 
annual Medicare+Choice capitation rate for the year was equal to the 
amount specified under subparagraph (D) of section 1853(c)(1), and not 
subparagraph (A), (B), or (C) of such section.
    ``(B) In order to carry out subsections (a)(1) and (b)(1) of 
section 1840, the Secretary shall transmit to the Commissioner of 
Social Security and the Railroad Retirement Board by the beginning of 
each year (beginning with 2006), such information determined 
appropriate by the Secretary, in consultation with the Commissioner of 
Social Security and the Railroad Retirement Board, regarding the amount 
of the monthly premium rate determined under paragraph (3) for 
individuals after the application of subparagraph (A).''.

SEC. 3. FUNDING REDUCTIONS IN THE MEDICARE PART B PREMIUM THROUGH 
              REDUCTIONS IN PAYMENTS TO MEDICARE ADVANTAGE 
              ORGANIZATIONS.

    Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)), as 
amended by section 2, is amended--
            (1) in paragraph (3), in the first sentence, by striking 
        ``paragraph (5)'' and inserting ``paragraphs (5) and (6)''; and
            (2) by adding at the end the following new paragraph:
    ``(6) For each year (beginning with 2006), the Secretary shall 
reduce the monthly premium rate determined under paragraph (3) for each 
month in the year for each individual enrolled under this part 
(including such an individual subject to an increased premium under 
subsection (b) or (i)) so that the aggregate amount of such reductions 
in the year is equal to an amount equal to--
            ``(A) the aggregate amount of reduced expenditures from the 
        Federal Supplementary Medicare Insurance Trust Fund in the year 
        that the Secretary estimates will result from the provisions 
        of, and the amendments made by, sections 4 and 5 of the 
        Affordability in Medicare Premiums Act of 2005; minus
            ``(B) the aggregate amount of reductions in the monthly 
        premium rate in the year pursuant to paragraph (5)(A).''.

SEC. 4. APPLICATION OF RISK ADJUSTMENT REFLECTING CHARACTERISTICS FOR 
              THE ENTIRE MEDICARE POPULATION IN PAYMENTS TO MEDICARE 
              ADVANTAGE ORGANIZATIONS.

    Effective January 1, 2006, 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. 5. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND (SLUSH 
              FUND).

    (a) In General.--Subsection (e) of section 1858 of the Social 
Security Act (42 U.S.C. 1395w-27a) is repealed.
    (b) Conforming Amendment.--Section 1858(f)(1) of the Social 
Security Act (42 U.S.C. 1395w-27a(f)(1)) is amended by striking 
``subject to subsection (e),''.
    (c) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 221(c) of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(Public Law 108-173; 117 Stat. 2181).
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