254 
(3) EFFECTIVE DATES.—The amendment made 
by paragraph (1) shall apply for plan years begin-
ning on or after January 1, 2009, and the amend-
ments made by paragraph (2) shall take effect on 
the date of the enactment of this Act. 
SEC. 422. DEVELOPMENT OF NEW QUALITY REPORTING 
MEASURES ON RACIAL DISPARITIES. 
(a) NEW QUALITY REPORTING MEASURES.— 
(1) IN
GENERAL.—Section 1852(e)(3) of the 
Social Security Act (42 U.S.C. 1395w–22(e)(3)), as 
amended by section 421(a)(2), is amended— 
(A) in subparagraph (B)— 
(i) in clause (i), by striking ‘‘The Sec-
retary’’ and inserting ‘‘Subject to subpara-
graph (D), the Secretary’’; and 
(ii) in clause (ii), by inserting ‘‘and 
subparagraph (C)’’ after ‘‘clause (iii)’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(D) ADDITIONAL
QUALITY
REPORTING 
MEASURES.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall develop by October 1, 2009, quality 
measures for Medicare Part C plans that 
measure disparities in the amount and 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00254
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
255 
quality of health services provided to racial 
and ethnic minorities. 
‘‘(ii) DATA TO MEASURE RACIAL AND 
ETHNIC DISPARITIES IN THE AMOUNT AND 
QUALITY OF CARE PROVIDED TO ENROLL-
EES.—The Secretary shall provide for 
Medicare Part C organizations to submit 
data under this paragraph, including data 
similar to those submitted for other quality 
measures, that permits analysis of dispari-
ties among racial and ethnic minorities in 
health services, quality of care, and health 
status among Medicare Part C plan enroll-
ees for use in submitting the reports under 
paragraph (5).’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply to reporting of quality 
measures for plan years beginning on or after Janu-
ary 1, 2010. 
(b) BIENNIAL REPORT ON RACIAL AND ETHNIC MI-
NORITIES.—Section 1852(e) of such Act (42 U.S.C. 
1395w–22(e)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(5) REPORT TO CONGRESS.— 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00255
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
256 
‘‘(A) IN GENERAL.—Not later than 2 years 
after the date of the enactment of this para-
graph, and biennially thereafter, the Secretary 
shall submit to Congress a report regarding 
how quality assurance programs conducted 
under this subsection measure and report on 
disparities in the amount and quality of health 
care services furnished to racial and ethnic mi-
norities. 
‘‘(B) CONTENTS OF REPORT.—Each such 
report shall include the following: 
‘‘(i) A description of the means by 
which such programs focus on such racial 
and ethnic minorities. 
‘‘(ii) An evaluation of the impact of 
such programs on eliminating health dis-
parities and on improving health outcomes, 
continuity and coordination of care, man-
agement of chronic conditions, and con-
sumer satisfaction. 
‘‘(iii) Recommendations on ways to re-
duce clinical outcome disparities among ra-
cial and ethnic minorities. 
‘‘(iv) Data for each MA plan from 
HEDIS and other source reporting the dis-
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00256
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
257 
parities in the amount and quality of 
health services furnished to racial and eth-
nic minorities.’’. 
SEC. 423. STRENGTHENING AUDIT AUTHORITY. 
(a) FOR PART C PAYMENTS RISK ADJUSTMENT.— 
Section 1857(d)(1) of the Social Security Act (42 U.S.C. 
1395w–27(d)(1)) is amended by inserting after ‘‘section 
1858(c))’’ the following: ‘‘, and data submitted with re-
spect to risk adjustment under section 1853(a)(3).’’. 
(b) 
ENFORCEMENT
OF
AUDITS
AND
DEFI-
CIENCIES.— 
(1) IN GENERAL.—Section 1857(e) of such Act 
is amended by adding at the end the following new 
paragraph: 
‘‘(4) ENFORCEMENT
OF
AUDITS
AND
DEFI-
CIENCIES.— 
‘‘(A) INFORMATION
IN
CONTRACT.—The 
Secretary shall require that each contract with 
a Medicare Part C organization under this sec-
tion shall include terms that inform the organi-
zation of the provisions in subsection (d). 
‘‘(B) ENFORCEMENT
AUTHORITY.—The 
Secretary is authorized, in connection with con-
ducting audits and other activities under sub-
section (d), to take such actions, including pur-
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00257
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
258 
suit of financial recoveries, necessary to address 
deficiencies identified in such audits or other 
activities.’’. 
(2) APPLICATION UNDER PART D.—For provi-
sion applying the amendment made by paragraph 
(1) to prescription drug plans under part D, see sec-
tion 1860D–12(b)(3)(D) of the Social Security Act. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect the date of the enactment 
of this Act and shall apply to audits and activities con-
ducted for contract years beginning on or after January 
1, 2009. 
SEC. 424. IMPROVING RISK ADJUSTMENT FOR MA PAY-
MENTS. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall submit to Congress a report 
that evaluates the adequacy of the Medicare Advantage 
risk adjustment system under section 1853(a)(1)(C) of the 
Social Security Act (42 U.S.C. 1395–23(a)(1)(C)). 
(b) PARTICULARS.—The report under subsection (a) 
shall include an evaluation of at least the following: 
(1) The need and feasibility of improving the 
adequacy of the risk adjustment system in predicting 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00258
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS