I 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. ADDRESSING SIGNIFICANT UNDER PROJEC4 TION OF MA LOCAL AREA GROWTH DUE TO 

5 WAGE INDEX RECLASSIFICATION. 

6 (a) LOCAL ADJUSTMENT METHOD AND APPLICA7 BILITY.—Section 1853(c)(6) of the Social Security Act 


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1 (42 U.S.C. 1395w–23(c)(6)) is amended at the end by 

2 adding the following new subparagraph: 

3 ‘‘(D) FURTHER ADJUSTMENT FOR SIGNIFI4 CANT UNDER PROJECTION OF LOCAL AREA

5 GROWTH.—Beginning with rates calculated for 

6 2025 when computing rates for purposes of cal7 culating benchmark amounts for an applicable 

8 plan, the Secretary shall adjust the growth per9 centage under subparagraph (A) to reflect the 

10 rate of growth in the MA local area, including 

11 making adjustments to growth estimates for 

12 previous years back no further than 2024. For 

13 purposes of this subparagraph, an applicable 

14 plan is an MA local plan in a service area where 

15 the area wage index under section 

16 1886(d)(3)(E) increased by more than 20 per17 cent in a prior year on average across the serv18 ice area of the plan. Upon request from an ap19 plicable plan, the Secretary shall issue the ad20 justment for that year for the MA local plan as 

21 soon as practicable.’’. 

22 (b) ADJUSTING THE BENCHMARK CAP.—Section 

23 1853(k)(1) of the Social Security Act (42 U.S.C. 1395w– 

24 23(k)(1)) is amended— 


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1 (1) in subparagraph (B)(i), by striking ‘‘adjust2 ment under subparagraph (C) of such subsection for 

3 a year before 2004’’ and inserting ‘‘adjustments 

4 under subparagraphs (C) or (D) of such subsection 

5 for a year before 2004 or 2024, respectively’’; and 

6 (2) in subparagraph (B)(ii) add the following 

7 new subparagraph: 

8 ‘‘(III) for an applicable plan 

9 under subsection (c)(6)(D), the 

10 amount specified in subsection 

11 (c)(1)(D) adjusted by the growth per12 centage determined under subsection 

13 (c)(6)(D)’’. 

14 (c) ADJUSTING THE BASE PAYMENT AMOUNT.—Sec15 tion 1853(n)(2)(E) of the Social Security Act (42 U.S.C. 

16 1395w–23(n)(2)(E)) is amended— 

17 (1) in clause (i)(I), by striking ‘‘adjustment 

18 under subparagraph (C) of such subsection for a 

19 year before 2004’’ and inserting ‘‘adjustments under 

20 subparagraphs (C) or (D) of such subsection for a 

21 year before 2004 or 2024, respectively’’; and 

22 (2) in clause (i)(II), by inserting ‘‘, or, for an 

23 applicable plan under subsection (c)(6)(D), the 

24 amount specified in subsection (c)(1)(D) adjusted by 


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1 the growth percentage determined under subsection 

2 (c)(6)(D)’’ before the period at the end. 

3 (d) IMMEDIATE IMPLEMENTATION TO ADDRESS

4 CURRENT UNDER PROJECTION OF LOCAL AREA

5 GROWTH.—Notwithstanding section 1853(b) of the Social 

6 Security Act and any other provision of law that would 

7 otherwise require prior notice, the Secretary shall take im8 mediate action to adopt or amend calendar year 2025 

9 Medicare Advantage Capitation Rates in accordance with 

10 the provisions of this section and to make any other meth11 odological changes or take other actions necessary and ap12 propriate to assure appropriate rate adjustments for MA 

13 local plans affected by significant under projection of local 

14 area growth as described in section 1853(c)(6)(D) of the 

15 Social Security Act made effective herewith, provided that 

16 if otherwise required notice of such actions shall be pub17 lished in the federal register as soon as possible and in 

18 any case within 30 days of such actions. 

Æ 


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