I 
112TH CONGRESS 
2D SESSION 
H. R. 4254 
To amend title XVIII of the Social Security Act to enhance Medicare 
Advantage program integrity. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 22, 2012 
Mr. STARK 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 juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to enhance 
Medicare Advantage program integrity. 
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 Advantage 
Program Integrity Act of 2012’’. 
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SEC. 2. MEDICARE ADVANTAGE CODING INTENSITY AD-
JUSTMENT. 
Section 1853(a)(1)(C)(ii)(III) of the Social Security 
Act (42 U.S.C. 1395w–23(a)(1)(C)(ii)(III)) is amended to 
read as follows: 
‘‘(III) In calculating each year’s ad-
justment, the adjustment factor shall be 
for 2014, not less than the adjustment fac-
tor applied for 2010, plus 1.3 percentage 
points; for each of years 2015 through 
2018, not less than the adjustment factor 
applied for the previous year, plus 0.6 per-
centage point; and for 2019 and each sub-
sequent year, not less than 7.1 percent.’’. 
SEC. 3. IMPLEMENTATION OF OFFICE OF INSPECTOR GEN-
ERAL RECOMMENDATION TO DELAY CERTAIN 
MEDICARE PLAN PREPAYMENTS. 
(a) MEDICARE
ADVANTAGE
PAYMENTS.—Section 
1853(a)(1) of the Social Security Act (42 U.S.C. 1395w– 
23(a)(1)) is amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i)— 
(A) by striking ‘‘subsections (e), (g), (i), 
and (l)’’ and inserting ‘‘subparagraph (I), sub-
sections (e), (g), (i), and (l),’’; and 
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(B) by inserting ‘‘(or, for months begin-
ning with January 2013, on the date specified 
in subparagraph (I))’’ after ‘‘in advance’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(I) TIMING OF PAYMENTS.— 
‘‘(i) IN
GENERAL.—With respect to 
monthly payments under this section for 
months beginning with January 2013, sub-
ject to clause (ii), the date specified in this 
subparagraph with respect to a payment 
for— 
‘‘(I) January is January 2nd; 
‘‘(II) February is February 15th; 
‘‘(III) March is March 30th; and 
‘‘(IV) April or any succeeding 
month in a year is the 15th day of the 
2nd succeeding month. 
‘‘(ii) HOLIDAYS, WEEKENDS, ETC.—If 
the date otherwise specified in clause (i) is 
a holiday or weekend, the date specified in 
this subparagraph shall be the first week-
day before such date.’’. 
(b) APPLICATION UNDER PART D.—Section 1860D– 
15(d)(1) of the Social Security Act (42 U.S.C. 1395w– 
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115(d)(1)) is amended by inserting ‘‘and shall be made 
consistent with the timing of monthly payments to MA 
organizations under section 1853(a)(1)(I)’’ after ‘‘as the 
Secretary determines’’. 
Æ 
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