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 com-
mittee 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 Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. ADDRESSING SIGNIFICANT UNDER PROJEC-
TION OF MA LOCAL AREA GROWTH DUE TO 
WAGE INDEX RECLASSIFICATION. 
(a) LOCAL ADJUSTMENT METHOD AND APPLICA-
BILITY.—Section 1853(c)(6) of the Social Security Act 
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(42 U.S.C. 1395w–23(c)(6)) is amended at the end by 
adding the following new subparagraph: 
‘‘(D) FURTHER ADJUSTMENT FOR SIGNIFI-
CANT
UNDER
PROJECTION
OF
LOCAL
AREA 
GROWTH.—Beginning with rates calculated for 
2025 when computing rates for purposes of cal-
culating benchmark amounts for an applicable 
plan, the Secretary shall adjust the growth per-
centage 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 per-
cent in a prior year on average across the serv-
ice area of the plan. Upon request from an ap-
plicable plan, the Secretary shall issue the ad-
justment 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— 
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(1) in subparagraph (B)(i), by striking ‘‘adjust-
ment 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 per-
centage determined under subsection 
(c)(6)(D)’’. 
(c) ADJUSTING THE BASE PAYMENT AMOUNT.—Sec-
tion 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 
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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 im-
mediate 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 meth-
odological changes or take other actions necessary and ap-
propriate 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 pub-
lished in the federal register as soon as possible and in 
any case within 30 days of such actions. 
Æ 
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