Title: Medicare Advantage Quality Expansion Act of 2017
Policy area: Health

Summary:
Medicare Advantage Quality Expansion Act of 2017
This bill, with respect to determining the benchmark amount applicable to Medicare Advantage (MA) plans, excludes certain percentage quality increases for specified new-entrant MA plans.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3756 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 3756

 To amend title XVIII of the Social Security Act to exclude MA quality 
 rating bonuses for certain new entrant Medicare Advantage plans from 
                             benchmark cap.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 13, 2017

 Ms. Blunt Rochester 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 jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to exclude MA quality 
 rating bonuses for certain new entrant Medicare Advantage plans from 
                             benchmark cap.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Advantage Quality Expansion 
Act of 2017''.

SEC. 2. MA QUALITY RATING BONUSES FOR CERTAIN NEW ENTRANT PLANS 
              EXCLUDED FROM BENCHMARK CAP.

    Section 1853 of the Social Security Act (42 U.S.C. 1395w-23) is 
amended--
            (1) in subsection (n) by amending paragraph (4) to read as 
        follows:
            ``(4) Cap on benchmark amount.--
                    ``(A) In general.--In no case shall the blended 
                benchmark amount for an area for a year (determined, 
                subject to subparagraph (B), taking into account 
                subsection (o)) be greater than the applicable amount 
                that would (but for the application of this subsection) 
                be determined under subsection (k)(1) for the area for 
                the year.
                    ``(B) Quality rating bonuses applicable to certain 
                new entrant plans not considered in blended benchmark 
                determination.--
                            ``(i) In general.--Subsection (o) shall not 
                        be taken into account in determining the 
                        blended benchmark for purposes of subparagraph 
                        (A) in the case of any increase under such 
                        subsection applicable to a Medicare Advantage 
                        plan that is a new entrant plan, with respect 
                        to an area, as described in clause (ii).
                            ``(ii) New entrant plan.--For purposes of 
                        clause (i), a Medicare Advantage plan is a new 
                        entrant plan, with respect to an area, if--
                                    ``(I) the plan is offered in such 
                                area beginning on or after January 1, 
                                2018, by an organization or sponsor 
                                that did not offer a Medicare Advantage 
                                plan in such area during the 3-year 
                                period preceding January 1, 2018; and
                                    ``(II) as of the date the plan is 
                                first offered in such area, there was 
                                not any other Medicare Advantage plan 
                                being offered in the area that was a 
                                qualifying plan (as defined in 
                                paragraph (3)(A)).''; and
            (2) in subsection (o), by adding at the end the following 
        new paragraph:
            ``(6) Increase in case of certain new entrant plans made 
        without regard to benchmark cap.--An increase under this 
        subsection, with respect to a new entrant plan (as described in 
        subsection (n)(4)(B)(ii)) for an area, shall be made to the 
        applicable percentage determined under subsection (n)(2)(B) 
        without regard to the limitation under subsection (n)(4)(A).''.
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