110 HR 5125 IH: To amend title XVIII of the Social Security Act to U.S. House of Representatives 2008-01-23 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 110th CONGRESS 2d Session H. R. 5125 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.

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). .