I 
116TH CONGRESS 
2D SESSION 
H. R. 6583 
To amend title XVIII of the Social Security Act to establish a risk corridor 
program for Medicare Advantage plans during the COVID–19 emergency, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 21, 2020 
Ms. HOULAHAN (for herself and Mr. LARSON of Connecticut) 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 consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend title XVIII of the Social Security Act to establish 
a risk corridor program for Medicare Advantage plans 
during the COVID–19 emergency, and for other pur-
poses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. ESTABLISHING A RISK CORRIDOR PROGRAM 
FOR MEDICARE ADVANTAGE PLANS DURING 
THE COVID–19 EMERGENCY. 
(a) IN GENERAL.—Section 1853 of the Social Secu-
rity Act (42 U.S.C. 1395w–23) is amended by adding at 
the end the following new subsection: 
‘‘(p) RISK
CORRIDOR
PROGRAM
DURING
THE 
COVID–19 EMERGENCY.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish and administer a program of risk corridors for 
each plan year, any portion of which occurs during 
the 
emergency 
period 
defined 
in 
section 
1135(g)(1)(B), under which the Secretary shall 
make payments to MA organizations offering a 
Medicare Advantage plan based on the ratio of the 
allowable costs of the plan to the aggregate pre-
miums of the plan. 
‘‘(2) PAYMENT METHODOLOGY.—The Secretary 
shall provide under the program established under 
paragraph (1) that if the allowable costs for a Medi-
care Advantage plan for any plan year are more 
than 105 percent of the target amount, the Sec-
retary shall pay to the plan an amount equal to 75 
percent of the allowable costs in excess of 105 per-
cent of the target amount. 
‘‘(3) TIMING.— 
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‘‘(A) SUBMISSION
OF
INFORMATION
BY 
PLANS.—With respect to a plan year for which 
the program described in paragraph (1) is es-
tablished and administered, not later than July 
1 of the succeeding plan year each MA organi-
zation offering a Medicare Advantage plan shall 
submit to the Secretary such information as the 
Secretary may require for purposes of carrying 
out such program. 
‘‘(B) PAYMENT.—The Secretary shall pay 
to an MA organization offering a Medicare Ad-
vantage plan eligible to receive a payment under 
the program with respect to a plan year the 
amount provided under paragraph (2) for such 
plan year not later than 60 days after such or-
ganization submits information with respect to 
such plan and plan year under subparagraph 
(A). 
‘‘(4) DEFINITIONS.— 
‘‘(A) ALLOWABLE COSTS.—The term ‘al-
lowable costs’ means, with respect to an MA or-
ganization offering a Medicare Advantage plan 
for a plan year, an amount equal to the total 
costs (other than administrative costs) of such 
plan in providing benefits covered by such plan, 
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but only to the extent that such costs are in-
curred with respect to such benefits for items 
and services that are benefits under the original 
medicare fee-for-service program option. 
‘‘(B) TARGET AMOUNT.—The term ‘target 
amount’ means, with respect to an MA organi-
zation offering a Medicare Advantage plan for 
a plan year, the total amount of payments paid 
to the MA organization for the plan for benefits 
under the original medicare fee-for-service pro-
gram option for the plan year, taking into ac-
count amounts paid by the Secretary and en-
rollees, based upon the bid amount submitted 
under section 1854, reduced by the total 
amount of administrative expenses for the year 
assumed in such bid. 
‘‘(5) FUNDING.—There are appropriated to the 
Centers for Medicare & Medicaid Services Program 
Management Account, out of any monies in the 
Treasury not otherwise obligated, such sums as may 
be necessary for purposes of carrying out this sub-
section.’’. 
(b) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
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Services may implement the amendments made by this 
section by program instruction or otherwise. 
Æ 
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