To amend title XVIII of the Social Security Act to provide for equitable reimbursement rates under the Medicare Program to Medicare+Choice organizations.

January 27, 2003

Mr. ISRAEL (for himself and Mr. ACKERMAN) 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

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 ANNUAL AREA-SPECIFIC MEDICARE+CHOICE 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 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

(B) by adding at the end the following new subparagraph:

`(D) ANNUAL AREA-SPECIFIC MEDICARE+CHOICE CAPITATION RATE- The annual area-specific Medicare+Choice capitation rate for the Medicare+Choice payment area, as determined under paragraph (3) for the year.'; and

(2) in paragraph (3), by striking `(1)(A)' and inserting `subparagraphs (A) and (D) of paragraph (1)'.

SEC. 3. PERMANENTLY REMOVING 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. 4. 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'.

END