I 
108TH CONGRESS 
2D SESSION 
H. R. 4304 
To amend the Medicare Prescription Drug, Improvement, and Modernization 
Act of 2003 to eliminate overpayments to health maintenance organiza-
tions and other private plans under part C of title XVIII of the Social 
Security Act. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 6, 2004 
Mr. BOSWELL (for himself, Ms. PELOSI, Mr. HOYER, Mr. MENENDEZ, Mr. 
GEORGE MILLER of California, Ms. DELAURO, Mr. MATSUI, Mr. RAN-
GEL, Mr. DINGELL, Mr. BERRY, Mr. BROWN of Ohio, Mr. STARK, Ms. 
SCHAKOWSKY, Mr. MCDERMOTT, Mr. PALLONE, Mr. GREEN of Texas, 
Mr. DOGGETT, Mr. ALLEN, Mr. SANDLIN, Ms. SOLIS, Mr. FROST, Mr. 
SERRANO, Ms. JACKSON-LEE of Texas, Mr. GRIJALVA, Mr. HOEFFEL, 
Ms. ESHOO, Mr. KILDEE, Mr. WEINER, Mr. FARR, Mr. WEXLER, Mr. 
HASTINGS of Florida, Mr. OLVER, Mr. NADLER, Mr. HINCHEY, Mr. 
TIERNEY, Mr. LANTOS, Mr. MORAN of Virginia, Mrs. MALONEY, Mr. 
ABERCROMBIE, Ms. KILPATRICK, Mr. CLAY, Mr. KENNEDY of Rhode Is-
land, Ms. WATERS, Mr. JACKSON of Illinois, Mr. HONDA, Ms. WATSON, 
Mr. RODRIGUEZ, Mr. GUTIERREZ, Mr. OBERSTAR, Mrs. LOWEY, Ms. 
LOFGREN, and Ms. SLAUGHTER) 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 de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 to eliminate overpay-
ments to health maintenance organizations and other 
private plans under part C of title XVIII of the Social 
Security Act.
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 Preservation 
and Anti-Privatization Act’’. 
SEC. 2. ELIMINATION OF MA REGIONAL PLAN STABILIZA-
TION FUND (SLUSH FUND). 
Subsection (e) of section 1858 of the Social Security 
Act, as added by section 221(c) of the Medicare Prescrip-
tion Drug, Improvement, and Modernization Act of 2003 
(Public Law 108–173), is repealed. 
SEC. 3. PHASE-IN TO PAYMENT AT 100 PERCENT OF FEE- 
FOR-SERVICE RATE. 
Notwithstanding any other provision of law, the Sec-
retary of Health and Human Services shall provide, begin-
ning with 2005, for adjustment of payment rates to orga-
nizations under section 1853 of the Social Security Act 
so that such payment rates reflect only the payment rate 
described in subsection (c)(1)(D) of such section (relating 
to 100 percent fee-for-service payment). 
SEC. 4. APPLICATION OF RISK ADJUSTMENT REFLECTING 
CHARACTERISTICS FOR THE ENTIRE MEDI-
CARE POPULATION. 
Notwithstanding any other provision of law, effective 
January 1, 2005, in applying risk adjustment factors to
payment to organizations under section 1853 of the Social 
Security Act (42 U.S.C. 1395w–23) in a budget neutral 
manner, the Secretary of Health and Human Services 
shall assure that such factors, in the aggregate, take into 
account the actuarial characteristics of the entire medicare 
population, and not merely the population of individuals 
enrolled under a plan under part C of title XVIII of such 
Act. 
Æ