[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4254 Introduced in House (IH)]

112th CONGRESS
  2d Session
                                H. R. 4254

  To amend title XVIII of the Social Security Act to enhance Medicare 
                      Advantage program integrity.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 22, 2012

  Mr. Stark 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 enhance Medicare 
                      Advantage program integrity.

    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 Advantage Program Integrity 
Act of 2012''.

SEC. 2. MEDICARE ADVANTAGE CODING INTENSITY ADJUSTMENT.

    Section 1853(a)(1)(C)(ii)(III) of the Social Security Act (42 
U.S.C. 1395w-23(a)(1)(C)(ii)(III)) is amended to read as follows:
                            ``(III) In calculating each year's 
                        adjustment, the adjustment factor shall be for 
                        2014, not less than the adjustment factor 
                        applied for 2010, plus 1.3 percentage points; 
                        for each of years 2015 through 2018, not less 
                        than the adjustment factor applied for the 
                        previous year, plus 0.6 percentage point; and 
                        for 2019 and each subsequent year, not less 
                        than 7.1 percent.''.

SEC. 3. IMPLEMENTATION OF OFFICE OF INSPECTOR GENERAL RECOMMENDATION TO 
              DELAY CERTAIN MEDICARE PLAN PREPAYMENTS.

    (a) Medicare Advantage Payments.--Section 1853(a)(1) of the Social 
Security Act (42 U.S.C. 1395w-23(a)(1)) is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i)--
                    (A) by striking ``subsections (e), (g), (i), and 
                (l)'' and inserting ``subparagraph (I), subsections 
                (e), (g), (i), and (l),''; and
                    (B) by inserting ``(or, for months beginning with 
                January 2013, on the date specified in subparagraph 
                (I))'' after ``in advance''; and
            (2) by adding at the end the following new subparagraph:
                    ``(I) Timing of payments.--
                            ``(i) In general.--With respect to monthly 
                        payments under this section for months 
                        beginning with January 2013, subject to clause 
                        (ii), the date specified in this subparagraph 
                        with respect to a payment for--
                                    ``(I) January is January 2nd;
                                    ``(II) February is February 15th;
                                    ``(III) March is March 30th; and
                                    ``(IV) April or any succeeding 
                                month in a year is the 15th day of the 
                                2nd succeeding month.
                            ``(ii) Holidays, weekends, etc.--If the 
                        date otherwise specified in clause (i) is a 
                        holiday or weekend, the date specified in this 
                        subparagraph shall be the first weekday before 
                        such date.''.
    (b) Application Under Part D.--Section 1860D-15(d)(1) of the Social 
Security Act (42 U.S.C. 1395w-115(d)(1)) is amended by inserting ``and 
shall be made consistent with the timing of monthly payments to MA 
organizations under section 1853(a)(1)(I)'' after ``as the Secretary 
determines''.
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