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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8561 Introduced in House (IH)]

<DOC>

118th CONGRESS
  2d Session
                                H. R. 8561

To amend title XVIII of the Social Security Act to address significant 
      under projection of MA local area growth due to wage index 
                           reclassification.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              May 23, 2024

 Ms. Tenney (for herself, Mr. Tonko, Ms. Stefanik, Mr. Williams of New 
  York, Mr. Morelle, Mr. Langworthy, and Mr. Molinaro) 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 address significant 
      under projection of MA local area growth due to wage index 
                           reclassification.

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

SECTION 1. ADDRESSING SIGNIFICANT UNDER PROJECTION OF MA LOCAL AREA 
              GROWTH DUE TO WAGE INDEX RECLASSIFICATION.

    (a) Local Adjustment Method and Applicability.--Section 1853(c)(6) 
of the Social Security Act (42 U.S.C. 1395w-23(c)(6)) is amended at the 
end by adding the following new subparagraph:
                    ``(D) Further adjustment for significant under 
                projection of local area growth.--Beginning with rates 
                calculated for 2025 when computing rates for purposes 
                of calculating benchmark amounts for an applicable 
                plan, the Secretary shall adjust the growth percentage 
                under subparagraph (A) to reflect the rate of growth in 
                the MA local area, including making adjustments to 
                growth estimates for previous years back no further 
                than 2024. For purposes of this subparagraph, an 
                applicable plan is an MA local plan in a service area 
                where the area wage index under section 1886(d)(3)(E) 
                increased by more than 20 percent in a prior year on 
                average across the service area of the plan. Upon 
                request from an applicable plan, the Secretary shall 
                issue the adjustment for that year for the MA local 
                plan as soon as practicable.''.
    (b) Adjusting the Benchmark Cap.--Section 1853(k)(1) of the Social 
Security Act (42 U.S.C. 1395w-23(k)(1)) is amended--
            (1) in subparagraph (B)(i), by striking ``adjustment under 
        subparagraph (C) of such subsection for a year before 2004'' 
        and inserting ``adjustments under subparagraphs (C) or (D) of 
        such subsection for a year before 2004 or 2024, respectively''; 
        and
            (2) in subparagraph (B)(ii) add the following new 
        subparagraph:
                                    ``(III) for an applicable plan 
                                under subsection (c)(6)(D), the amount 
                                specified in subsection (c)(1)(D) 
                                adjusted by the growth percentage 
                                determined under subsection 
                                (c)(6)(D)''.
    (c) Adjusting the Base Payment Amount.--Section 1853(n)(2)(E) of 
the Social Security Act (42 U.S.C. 1395w-23(n)(2)(E)) is amended--
            (1) in clause (i)(I), by striking ``adjustment under 
        subparagraph (C) of such subsection for a year before 2004'' 
        and inserting ``adjustments under subparagraphs (C) or (D) of 
        such subsection for a year before 2004 or 2024, respectively''; 
        and
            (2) in clause (i)(II), by inserting ``, or, for an 
        applicable plan under subsection (c)(6)(D), the amount 
        specified in subsection (c)(1)(D) adjusted by the growth 
        percentage determined under subsection (c)(6)(D)'' before the 
        period at the end.
    (d) Immediate Implementation To Address Current Under Projection of 
Local Area Growth.--Notwithstanding section 1853(b) of the Social 
Security Act and any other provision of law that would otherwise 
require prior notice, the Secretary shall take immediate action to 
adopt or amend calendar year 2025 Medicare Advantage Capitation Rates 
in accordance with the provisions of this section and to make any other 
methodological changes or take other actions necessary and appropriate 
to assure appropriate rate adjustments for MA local plans affected by 
significant under projection of local area growth as described in 
section 1853(c)(6)(D) of the Social Security Act made effective 
herewith, provided that if otherwise required notice of such actions 
shall be published in the federal register as soon as possible and in 
any case within 30 days of such actions.
                                 <all>
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