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vailing rate in the market, but in no case higher 
than 11 percent.’’. 
(e) DISALLOWANCE OF GLOBAL BILLING.—Effective 
for claims filed for imaging services (as defined in sub-
section (b)(4)(B) of section 1848 of the Social Security 
Act) furnished on or after the first day of the first month 
that begins more than 1 year after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services shall not accept (or pay) a claim under such sec-
tion unless the claim is made separately for each compo-
nent of such services. 
(f) EFFECTIVE DATE.—Except as otherwise pro-
vided, this section, and the amendments made by this sec-
tion, shall apply to services furnished on or after January 
1, 2008. 
SEC. 310. REDUCING FREQUENCY OF MEETINGS OF THE 
PRACTICING PHYSICIANS ADVISORY COUN-
CIL. 
Section 1868(a)(2) of the Social Security Act (42 
U.S.C. 1395ee(a)(2)) is amended by striking ‘‘once during 
each calendar quarter’’ and inserting ‘‘once each year (and 
at such other times as the Secretary may specify)’’. 
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TITLE IV—MEDICARE 
ADVANTAGE REFORMS 
Subtitle A—Payment Reform 
SEC. 401. EQUALIZING PAYMENTS BETWEEN MEDICARE AD-
VANTAGE 
PLANS 
AND 
FEE-FOR-SERVICE 
MEDICARE. 
(a) PHASE IN OF PAYMENT BASED ON FEE-FOR- 
SERVICE COSTS.—Section 1853 of the Social Security Act 
(42 U.S.C. 1395w–23) is amended— 
(1) in subsection (j)(1)(A)— 
(A) by striking ‘‘beginning with 2007’’ and 
inserting ‘‘for 2007 and 2008’’; and 
(B) by inserting after ‘‘(k)(1)’’ the fol-
lowing: ‘‘, or, beginning with 2009, 1⁄12 of the 
blended benchmark amount determined under 
subsection (l)(1)’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(l) DETERMINATION
OF BLENDED BENCHMARK 
AMOUNT.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(j), subject to paragraphs (2) and (3), the term 
‘blended benchmark amount’ means for an area— 
‘‘(A) for 2009 the sum of— 
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‘‘(i) 2⁄3 of the applicable amount (as 
defined in subsection (k)(1)) for the area 
and year; and 
‘‘(ii) 1⁄3 of the amount specified in 
subsection (c)(1)(D)(i) for the area and 
year; 
‘‘(B) for 2010 the sum of— 
‘‘(i) 1⁄3 of the applicable amount for 
the area and year; and 
‘‘(ii) 2⁄3 of the amount specified in 
subsection (c)(1)(D)(i) for the area and 
year; and 
‘‘(C) for a subsequent year the amount 
specified in subsection (c)(1)(D)(i) for the area 
and year. 
‘‘(2) FEE-FOR-SERVICE
PAYMENT
FLOOR.—In 
no case shall the blended benchmark amount for an 
area and year be less than the amount specified in 
subsection (c)(1)(D)(i) for the area and year. 
‘‘(3) EXCEPTION FOR PACE PLANS.—This sub-
section shall not apply to payments to a PACE pro-
gram under section 1894.’’. 
(b) PHASE
IN
OF
PAYMENT
BASED
ON
IME 
COSTS.— 
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(1) IN GENERAL.—Section 1853(c)(1)(D)(i) of 
such Act (42 U.S.C. 1395w–23(c)(1)(D)(i)) is 
amended by inserting ‘‘and costs attributable to pay-
ments 
under 
section 
1886(d)(5)(B)’’ 
after 
‘‘1886(h)’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to the capitation rate 
for years beginning with 2009. 
(c) LIMITATION ON PLAN ENROLLMENT IN CASES OF 
EXCESS BIDS FOR 2009 AND 2010.— 
(1) IN GENERAL.—In the case of a Medicare 
Part C organization that offers a Medicare Part C 
plan in the 50 States or the District of Columbia for 
which— 
(A) bid amount described in paragraph (2) 
for a Medicare Part C plan for 2009 or 2010, 
exceeds 
(B) the percent specified in paragraph (4) 
of the fee-for-service amount described in para-
graph (3), 
the Medicare Part C plan may not enroll any new 
enrollees in the plan during the annual, coordinated 
election period (under section 1851(e)(3)(B) of such 
Act (42 U.S.C. 1395w–21(e)(3)(B)) for the year or 
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during the year (if the enrollment becomes effective 
during the year). 
(2) BID AMOUNT FOR PART A AND B SERV-
ICES.— 
(A) IN GENERAL.—Except as provided in 
subparagraph (B), the bid amount described in 
this paragraph is the unadjusted Medicare Part 
C statutory non-drug monthly bid amount (as 
defined in section 1854(b)(2)(E) of the Social 
Security Act (42 U.S.C. 1395w–24(b)(2)(E)). 
(B) TREATMENT OF MSA PLANS.—In the 
case of an MSA plan (as defined in section 
1859(b)(3) of the Social Security Act, 42 
U.S.C. 1935w–28(b)(3)), the bid amount de-
scribed in this paragraph is the amount de-
scribed in section 1854(a)(3)(A) of such Act 
(42 U.S.C. 1395w–24(a)(3)(A)). 
(3) FEE-FOR-SERVICE AMOUNT DESCRIBED.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the fee-for-service amount described 
in this paragraph for an Medicare Part C local 
area is the amount described in section 
1853(c)(1)(D)(i) of the Social Security Act (42 
U.S.C. 1395w–23) for such area. 
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(B) 
TREATMENT
OF
MULTI-COUNTY 
PLANS.—In the case of an MA plan the service 
area for which covers more than one Medicare 
Part C local area, the fee-for-service amount 
described in this paragraph is the amount de-
scribed in section 1853(c)(1)(D)(i) of the Social 
Security Act for each such area served, weight-
ed for each such area by the proportion of the 
enrollment of the plan that resides in the coun-
ty (as determined based on amounts posted by 
the Administrator of the Centers for Medicare 
& Medicaid Services in the April bid notice for 
the year involved). 
(4) PERCENTAGE PHASE DOWN.—For purposes 
of paragraph (1), the percentage specified in this 
paragraph— 
(A) for 2009 is 106 percent; and 
(B) for 2010 is 103 percent. 
(5) EXEMPTION OF AGE-INS.—For purposes of 
paragraph (1), the term ‘‘new enrollee’’ with respect 
to a Medicare Part C plan offered by a Medicare 
Part C organization, does not include an individual 
who was enrolled in a plan offered by the organiza-
tion in the month immediately before the month in 
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