209 
niques or modalities, including radiant energy 
or ionizing radiation and ultrasound and mag-
netic resonance. Such term does not include 
image guided procedures. 
‘‘(D) MEDICAL
IMAGING
SERVICE.—The 
term ‘medical imaging service’ means a service 
that involves the science of an image.’’. 
(b) ADJUSTMENT IN PRACTICE EXPENSE TO REFLECT 
HIGHER PRESUMED UTILIZATION.—Section 1848 of the 
Social Security Act (42 U.S.C. 1395w) is amended— 
(1) in subsection (b)(4)— 
(A) in subparagraph (B), by striking ‘‘sub-
paragraph (A)’’ and inserting ‘‘this paragraph’’; 
and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(D) ADJUSTMENT IN PRACTICE EXPENSE 
TO REFLECT HIGHER PRESUMED UTILIZATION.— 
In computing the number of practice expense rel-
ative value units under subsection (c)(2)(C)(ii) 
with respect to imaging services described in sub-
paragraph (B), the Secretary shall adjust such 
number of units so it reflects a 75 percent (rath-
er than 50 percent) presumed rate of utilization 
of imaging equipment.’’; and 
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210 
(2) in subsection (c)(2)(B)(v)(II), by inserting 
‘‘AND OTHER PROVISIONS’’ after ‘‘OPD PAYMENT CAP’’ 
(c) ADJUSTMENT IN TECHNICAL COMPONENT ‘‘DIS-
COUNT’’ ON SINGLE-SESSION IMAGING TO CONSECUTIVE 
BODY PARTS.—Section 1848(b)(4) of such Act is further 
amended by adding at the end the following new subpara-
graph: 
‘‘(E) ADJUSTMENT IN TECHNICAL COMPO-
NENT DISCOUNT ON SINGLE-SESSION IMAGING IN-
VOLVING CONSECUTIVE BODY PARTS.—The Sec-
retary shall increase the reduction in expendi-
tures attributable to the multiple procedure pay-
ment reduction applicable to the technical com-
ponent for imaging under the final rule pub-
lished by the Secretary in the Federal Register 
on November 21, 2005 (42 CFR 405, et al.) from 
25 percent to 50 percent.’’. 
(d) ADJUSTMENT IN ASSUMED INTEREST RATE FOR 
CAPITAL PURCHASES.—Section 1848(b)(4) of such Act is 
further amended by adding at the end the following new 
subparagraph: 
‘‘(F) ADJUSTMENT IN ASSUMED INTEREST 
RATE FOR CAPITAL PURCHASES.—In computing 
the practice expense component for imaging serv-
ices under this section, the Secretary shall 
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211 
change the interest rate assumption for capital 
purchases of imaging devices to reflect the pre-
vailing rate in the market, but in no case higher 
than 11 percent.’’. 
(e) DISALLOWANCE OF GLOBAL BILLING.—Effective 
for claims filed for imaging services (as defined in sub-
section (b)(4)(B) of section 1848 of the Social Security Act) 
furnished on or after the first day of the first month that 
begins more than 1 year after the date of the enactment 
of this Act, the Secretary of Health and Human Services 
shall not accept (or pay) a claim under such section unless 
the claim is made separately for each component of such 
services. 
(f) EFFECTIVE DATE.—Except as otherwise provided, 
this section, and the amendments made by this section, shall 
apply to services furnished on or after January 1, 2008. 
SEC. 310. REDUCING FREQUENCY OF MEETINGS OF THE 
PRACTICING PHYSICIANS ADVISORY COUN-
CIL. 
Section 1868(a)(2) of the Social Security Act (42 
U.S.C. 1395ee(a)(2)) is amended by striking ‘‘once during 
each calendar quarter’’ and inserting ‘‘once each year (and 
at such other times as the Secretary may specify)’’. 
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212 
TITLE IV—MEDICARE 
ADVANTAGE REFORMS 
Subtitle A—Payment Reform 
SEC. 401. EQUALIZING PAYMENTS BETWEEN MEDICARE AD-
VANTAGE 
PLANS 
AND 
FEE-FOR-SERVICE 
MEDICARE. 
(a) PHASE IN OF PAYMENT BASED ON FEE-FOR-SERV-
ICE COSTS.—Section 1853 of the Social Security Act (42 
U.S.C. 1395w–23) is amended— 
(1) in subsection (j)(1)(A)— 
(A) by striking ‘‘beginning with 2007’’ and 
inserting ‘‘for 2007 and 2008’’; and 
(B) by inserting after ‘‘(k)(1)’’ the fol-
lowing: ‘‘, or, beginning with 2009, 1⁄12 of the 
blended benchmark amount determined under 
subsection (l)(1)’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(l) DETERMINATION
OF
BLENDED
BENCHMARK 
AMOUNT.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(j), subject to paragraphs (2) and (3), the term ‘blend-
ed benchmark amount’ means for an area— 
‘‘(A) for 2009 the sum of— 
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213 
‘‘(i) 2⁄3 of the applicable amount (as 
defined in subsection (k)(1)) for the area 
and year; and 
‘‘(ii) 1⁄3 of the amount specified in sub-
section (c)(1)(D)(i) for the area and year; 
‘‘(B) for 2010 the sum of— 
‘‘(i) 1⁄3 of the applicable amount for 
the area and year; and 
‘‘(ii) 2⁄3 of the amount specified in sub-
section (c)(1)(D)(i) for the area and year; 
and 
‘‘(C) for a subsequent year the amount spec-
ified in subsection (c)(1)(D)(i) for the area and 
year. 
‘‘(2) FEE-FOR-SERVICE PAYMENT FLOOR.—In no 
case shall the blended benchmark amount for an area 
and year be less than the amount specified in sub-
section (c)(1)(D)(i) for the area and year. 
‘‘(3) EXCEPTION FOR PACE PLANS.—This sub-
section shall not apply to payments to a PACE pro-
gram under section 1894.’’. 
(b) PHASE IN OF PAYMENT BASED ON IME COSTS.— 
(1) IN
GENERAL.—Section 1853(c)(1)(D)(i) of 
such Act (42 U.S.C. 1395w–23(c)(1)(D)(i)) is amend-
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214 
ed by inserting ‘‘and costs attributable to payments 
under section 1886(d)(5)(B)’’ after ‘‘1886(h)’’. 
(2) EFFECTIVE DATE.—The amendment made by 
paragraph (1) shall apply to the capitation rate for 
years beginning with 2009. 
(c) LIMITATION ON PLAN ENROLLMENT IN CASES OF 
EXCESS BIDS FOR 2009 AND 2010.— 
(1) IN
GENERAL.—In the case of a Medicare 
Part C organization that offers a Medicare Part C 
plan in the 50 States or the District of Columbia for 
which— 
(A) bid amount described in paragraph (2) 
for a Medicare Part C plan for 2009 or 2010, ex-
ceeds 
(B) the percent specified in paragraph (4) 
of the fee-for-service amount described in para-
graph (3), 
the Medicare Part C plan may not enroll any new en-
rollees in the plan during the annual, coordinated 
election period (under section 1851(e)(3)(B) of such 
Act (42 U.S.C. 1395w–21(e)(3)(B)) for the year or 
during the year (if the enrollment becomes effective 
during the year). 
(2) BID AMOUNT FOR PART A AND B SERVICES.— 
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215 
(A) IN GENERAL.—Except as provided in 
subparagraph (B), the bid amount described in 
this paragraph is the unadjusted Medicare Part 
C statutory non-drug monthly bid amount (as 
defined in section 1854(b)(2)(E) of the Social Se-
curity Act (42 U.S.C. 1395w–24(b)(2)(E)). 
(B) TREATMENT
OF
MSA
PLANS.—In the 
case of an MSA plan (as defined in section 
1859(b)(3) of the Social Security Act, 42 U.S.C. 
1935w–28(b)(3)), the bid amount described in 
this paragraph is the amount described in sec-
tion 1854(a)(3)(A) of such Act (42 U.S.C. 
1395w–24(a)(3)(A)). 
(3) FEE-FOR-SERVICE AMOUNT DESCRIBED.— 
(A) IN GENERAL.—Subject to subparagraph 
(B), the fee-for-service amount described in this 
paragraph for an Medicare Part C local area is 
the amount described in section 1853(c)(1)(D)(i) 
of the Social Security Act (42 U.S.C. 1395w–23) 
for such area. 
(B) 
TREATMENT
OF
MULTI-COUNTY 
PLANS.—In the case of an MA plan the service 
area for which covers more than one Medicare 
Part C local area, the fee-for-service amount de-
scribed in this paragraph is the amount de-
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scribed in section 1853(c)(1)(D)(i) of the Social 
Security Act for each such area served, weighted 
for each such area by the proportion of the en-
rollment of the plan that resides in the county 
(as determined based on amounts posted by the 
Administrator of the Centers for Medicare & 
Medicaid Services in the April bid notice for the 
year involved). 
(4) PERCENTAGE PHASE DOWN.—For purposes of 
paragraph (1), the percentage specified in this para-
graph— 
(A) for 2009 is 106 percent; and 
(B) for 2010 is 103 percent. 
(5) EXEMPTION OF AGE-INS.—For purposes of 
paragraph (1), the term ‘‘new enrollee’’ with respect 
to a Medicare Part C plan offered by a Medicare Part 
C organization, does not include an individual who 
was enrolled in a plan offered by the organization in 
the month immediately before the month in which the 
individual was eligible to enroll in such a Medicare 
Part C plan offered by the organization. 
(d) 
ANNUAL
REBASING
OF
FEE-FOR-SERVICE 
RATES.—Section 1853(c)(1)(D)(ii) of the Social Security 
Act (42 U.S.C. 1395w–23(c)(1)(D)(ii)) is amended— 
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