I 
115TH CONGRESS 
1ST SESSION H. R. 3756 
To amend title XVIII of the Social Security Act to exclude MA quality 
rating bonuses for certain new entrant Medicare Advantage plans from 
benchmark cap. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 13, 2017 
Ms. BLUNT ROCHESTER 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 with-
in the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to exclude 
MA quality rating bonuses for certain new entrant Medi-
care Advantage plans from benchmark cap. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Advantage 
Quality Expansion Act of 2017’’. 
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SEC. 2. MA QUALITY RATING BONUSES FOR CERTAIN NEW 
ENTRANT PLANS EXCLUDED FROM BENCH-
MARK CAP. 
Section 1853 of the Social Security Act (42 U.S.C. 
1395w–23) is amended— 
(1) in subsection (n) by amending paragraph 
(4) to read as follows: 
‘‘(4) CAP ON BENCHMARK AMOUNT.— 
‘‘(A) IN GENERAL.—In no case shall the 
blended benchmark amount for an area for a 
year (determined, subject to subparagraph (B), 
taking into account subsection (o)) be greater 
than the applicable amount that would (but for 
the application of this subsection) be deter-
mined under subsection (k)(1) for the area for 
the year. 
‘‘(B) QUALITY RATING BONUSES APPLICA-
BLE TO CERTAIN NEW ENTRANT PLANS NOT 
CONSIDERED IN BLENDED BENCHMARK DETER-
MINATION.— 
‘‘(i) IN
GENERAL.—Subsection (o) 
shall not be taken into account in deter-
mining the blended benchmark for pur-
poses of subparagraph (A) in the case of 
any increase under such subsection appli-
cable to a Medicare Advantage plan that is 
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a new entrant plan, with respect to an 
area, as described in clause (ii). 
‘‘(ii) NEW ENTRANT PLAN.—For pur-
poses of clause (i), a Medicare Advantage 
plan is a new entrant plan, with respect to 
an area, if— 
‘‘(I) the plan is offered in such 
area beginning on or after January 1, 
2018, by an organization or sponsor 
that did not offer a Medicare Advan-
tage plan in such area during the 3- 
year period preceding January 1, 
2018; and 
‘‘(II) as of the date the plan is 
first offered in such area, there was 
not any other Medicare Advantage 
plan being offered in the area that 
was a qualifying plan (as defined in 
paragraph (3)(A)).’’; and 
(2) in subsection (o), by adding at the end the 
following new paragraph: 
‘‘(6) INCREASE IN CASE OF CERTAIN NEW EN-
TRANT PLANS MADE WITHOUT REGARD TO BENCH-
MARK CAP.—An increase under this subsection, with 
respect to a new entrant plan (as described in sub-
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section (n)(4)(B)(ii)) for an area, shall be made to 
the applicable percentage determined under sub-
section (n)(2)(B) without regard to the limitation 
under subsection (n)(4)(A).’’. 
Æ 
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