I
106TH CONGRESS
2D SESSION
H. R. 4968
To amend title XVIII of the Social Security Act to provide for equitable
reimbursement rates under the Medicare Program to Medicare+Choice
organizations.
IN THE HOUSE OF REPRESENTATIVES
JULY 26, 2000
Ms. DUNN (for herself, Mr. KLECZKA, and Mr. MCDERMOTT) introduced the
following bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Commerce, for a period to be subse-
quently 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 provide
for equitable reimbursement rates under the Medicare
Program to Medicare+Choice organizations.
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 Equity and
Access Act of 2000’’.
SEC. 
2. 
ELIMINATION 
OF 
REDUCTION 
IN
MEDICARE+CHOICE 
PAYMENT 
RATES 
BY
BUDGET NEUTRALITY ADJUSTMENTS.
(a) IN GENERAL.—Section 1853(c)(1)(A) of the So-
cial Security Act (42 U.S.C. 1395w–23(c)(1)(A)) is
amended by adding at the end the following: ‘‘With respect
to years beginning on or after January 1, 2001, in no case
shall the budget neutrality adjustment provided for in the
previous sentence result in a reduction of the payment
amount that would otherwise be made under this subpara-
graph but for such adjustment.’’.
(b) TRANSITIONAL RULE IN 2000 FOR SUBMISSION
OF REQUIRED INFORMATION.—Notwithstanding section
1854(a)(1) of the Social Security Act (42 U.S.C. 1395w–
24(a)(1)), the deadline for a Medicare+Choice organiza-
tion offering of a Medicare+Choice plan under part C of
title XVIII of the Social Security Act to submit informa-
tion, including the adjusted community rate (as defined
in subsection (f)(3) of that section), required for the offer-
ing of such a plan for 2001 is delayed from July 1, 2000,
to December 1, 2000.
SEC. 3. ACCELERATION OF MOVEMENT TO 50:50 PERCENT
BLEND IN 2001.
Section 1853(c)(2) of the Social Security Act (42
U.S.C. 1395w–23(c)(2)) is amended—
(1) by adding ‘‘and’’ at the end of subpara-
graph (C);
(2) by striking subparagraphs (D) and (E);
(3) by redesignating subparagraph (F) as sub-
paragraph (D); and
(4) in subparagraph (D), as so redesignated, by
striking ‘‘2002’’ and inserting ‘‘2000’’.
SEC. 4. INCREASE IN BASELINE OF NATIONAL PER CAPITA
MEDICARE+CHOICE GROWTH PERCENTAGE
FOR YEARS AFTER 2000.
(a) IN GENERAL.—Section 1853(c)(6)(B) of the So-
cial Security Act (42 U.S.C. 1395w–23(c)(6)(B)) is
amended—
(1) in clause (i), by striking ‘‘0.8 percentage
points’’ and inserting ‘‘0 percentage points’’; and
(2) in clause (ii), by striking ‘‘0.5 percentage
points’’ and inserting ‘‘0 percentage points’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall apply with respect to payment rates
calculated for months beginning on or after January 1,
2001.
SEC. 5. INCLUSION OF COSTS OF DOD MILITARY TREAT-
MENT FACILITY SERVICES TO MEDICARE-ELI-
GIBLE BENEFICIARIES IN CALCULATION OF
MEDICARE+CHOICE PAYMENT RATES.
Section 1853(c)(3) of the Social Security Act (42
U.S.C. 1395w–23(c)(3)) is amended—
(1) in subparagraph (A), by striking ‘‘subpara-
graph (B)’’ and inserting ‘‘subparagraphs (B) and
(E)’’, and
(2) by adding at the end the following new sub-
paragraph:
‘‘(E) INCLUSION
OF
COSTS
OF
CERTAIN
DOD MILITARY TREATMENT FACILITY SERVICES
TO MEDICARE-ELIGIBLE BENEFICIARIES.—
‘‘(i) IN
GENERAL.—In determining
the area-specific Medicare+Choice capita-
tion rate under subparagraph (A) for a
year (beginning with 2001), the annual per
capita rate of payment for 1997 deter-
mined under section 1876(a)(1)(C) for a
Medicare+Choice payment area that is
within one or more MTF affected areas (as
defined in clause (ii)) shall be increased by
the sum of the MTF percentages (as de-
scribed in clause (iii)) for the MTF af-
fected area or areas. The increase under
ices to individuals entitled to benefits
under this title who received services
from the military treatment facility
described in clause (ii) for that area
in 1996 (as determined pursuant to
section 1896(j)(1)(A)), increased by
the 
national 
per 
capita
Medicare+Choice growth percentage
under paragraph (6) for 1997, to
‘‘(II) the average number of indi-
viduals residing in such area in 1996
entitled to benefits under part A and
enrolled under part B.’’.
Æ