[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5125 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 5125

   To amend title XVIII of the Social Security Act to provide for a 
Medicare Advantage benchmark adjustment for certain local areas with VA 
           medical centers and for certain contiguous areas.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 23, 2008

  Mr. Israel (for himself and Mr. Bishop of New York) 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 title XVIII of the Social Security Act to provide for a 
Medicare Advantage benchmark adjustment for certain local areas with VA 
           medical centers and for certain contiguous areas.

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

SECTION 1. MEDICARE ADVANTAGE BENCHMARK ADJUSTMENT FOR CERTAIN LOCAL 
              AREAS WITH VA MEDICAL CENTERS AND FOR CERTAIN CONTIGUOUS 
              AREAS.

    Section 1853(k) of the Social Security Act (42 U.S.C. 1395w-23(k)) 
is amended--
            (1) in paragraph (1), in the matter preceding subparagraph 
        (A), by striking ``paragraph (2)'' and inserting ``paragraphs 
        (2) and (4)''; and
            (2) by adding at the end the following new paragraph:
            ``(4) Adjustment for certain ma local areas with va medical 
        centers and for certain contiguous areas.--
                    ``(A) In general.--In applying paragraph (1) for 
                plan year 2009 and subsequent plan years, in the case 
                of a targeted MA local area described in subparagraph 
                (B) that is contiguous to one MA local area described 
                in subparagraph (C), if the applicable amounts 
                determined under such paragraph for such areas for a 
                year are not equal, the applicable amount determined 
                under such paragraph for each of such areas for the 
                year shall be deemed to be the greater of such amounts.
                    ``(B) Targeted ma local area.--For purposes of 
                subparagraph (A), a targeted MA local area is a 
                county--
                            ``(i) that has within its boundaries a 
                        facility that is an academic medical center of 
                        the Department of Veterans Affairs; and
                            ``(ii) for which the payment amount under 
                        this section for each of 2004, 2005, and 2007 
                        was determined using the amount specified under 
                        subsection (c)(1)(D) for such area for such 
                        year.
                    ``(C) Contiguous ma local area.--For purposes of 
                subparagraph (A), an MA local area described in this 
                subparagraph is a county that--
                            ``(i) does not have within its boundaries a 
                        facility described in subparagraph (B)(i); and
                            ``(ii) meets the criteria described in 
                        subparagraph (B)(ii).''.
                                 <all>