ble requirements for such costs under the Federal 
Acquisition Regulation’’. 
(c) APPLICATION TO PRESCRIPTION DRUG PLANS.— 
The amendments made by subsections (a) and (b) apply, 
pursuant to section 1860D–12(b)(3) of the Social Security 
Act (42 U.S.C. 1395w–112(b)(3)), to contracts with pre-
scription drug sponsors under part D of title XVIII of 
such Act. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply for contract years beginning after 
the date of the enactment of this Act. 
SEC. 3. FINANCIAL TRANSPARENCY. 
(a) 
MEDICARE
ADVANTAGE
PLANS.—Section 
1851(d) of the Social Security Act (42 U.S.C. 1395w– 
21(d)) is amended by adding at the end the following new 
paragraph: 
‘‘(8) FINANCIAL TRANSPARENCY.— 
‘‘(A) IN GENERAL.—Each MA organization 
shall provide annually to the Secretary (in a 
form and manner specified by the Secretary), 
with respect to each MA plan it offers and not 
later than 3 months after the end of each con-
tract year, information describing the organiza-
tion’s compliance with the requirements of sec-
tion 1857(e)(4) and a functional listing of the
organization’s administrative costs (by category 
of such costs, including, at a minimum, mar-
keting costs and claims processing costs), prof-
its, and investment income (as defined by the 
Secretary), as a ratio of aggregate average reve-
nues collected under the contract for that year. 
‘‘(B) PUBLICATION.—The Secretary shall 
publish the information provided under sub-
paragraph (A) for each MA plan.’’. 
(b) CONFORMING APPLICATION
TO PRESCRIPTION 
DRUG PLANS.—Section 1860D–11(b)(2) of the Social Se-
curity Act 1395w–111(b)(2)) is amended by redesignating 
subparagraph (F) as subparagraph (G) and by inserting 
after subparagraph (E) the following new subparagraph: 
‘‘(F) PERIODIC
AUDITING.—Information 
with respect to the prescription drug plan of the 
type described in section 1851(d)(8) with re-
spect to an MA plan.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to reporting of information for con-
tract years to which the amendments made by section 2 
apply. 
SEC. 4. BENEFICIARY SIGN-OFF. 
(a) 
MEDICARE
ADVANTAGE
PLANS.—Section 
1851(c)(2) of the Social Security Act (42 U.S.C. 1395w–
21(c)(2)) is amended by adding at the end the following 
new subparagraph: 
‘‘(C) BENEFICIARY SIGN-OFF IN ELECTION 
PROCESS.—An election to enroll with an MA 
plan shall not be effective unless the election 
form is signed by the individual and specifically 
acknowledges each of the following: 
‘‘(i) The premiums, cost-sharing re-
quirements, and benefits under the plan 
may change at the beginning of each 12- 
month contract period. 
‘‘(ii) The individual may lose coverage 
of the individual’s physician or other pro-
vider at the beginning of each such period. 
‘‘(iii) The plan may be terminated at 
the beginning of any such period. 
‘‘(iv) Premiums and benefits under 
the plan may vary based on the county or 
other MA area in which the plan is of-
fered.’’. 
(b) APPLICATION TO PRESCRIPTION DRUG PLANS.— 
The amendment made by subsection (a) applies, pursuant 
to section 1860D–1(b)(1)(B)(ii) of the Social Security Act 
(42 U.S.C. 1395w–101(b)(1)(B)(ii)), to prescription drug 
plans under part D of title XVIII of such Act.