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SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ''Medicare+Choice
Program Improvement Act of 2000''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Increase in national per capita Medicare+Choice growth
percentage in 2001 and 2002.
Sec. 3. Increasing minimum payment amount.
Sec. 4. Allowing movement to 50:50 percent blend in 2002.
Sec. 5. Increased update for payment areas with only one or no
Medicare+Choice contracts.
Sec. 6. Permitting higher negotiated rates in certain Medicare+Choice
payment areas below national average.
Sec. 7. 10-year phase-in of risk adjustment based on data from all
settings.
Sec. 8. Delay from July to November 2000 in deadline for offering and
withdrawing Medicare+Choice plans for 2001.

SEC. 2. INCREASE IN NATIONAL PER CAPITA MEDICARE+CHOICE GROWTH
PERCENTAGE IN 2001 AND 2002.

Section 1853(c)(6)(B) of the Social Security Act (42 U.S.C. 1395w-
23(c)(6)(B)) is amended--
(1) in clause (iii), by adding ''and'' at the end;
(2) by striking clauses (iv) and (v);
(3) by redesignating clause (vi) as clause (iv); and
(4) in clause (iv), as so redesignated, by striking ''after
2002'' and inserting ''after 2000''.

SEC. 3. INCREASING MINIMUM PAYMENT AMOUNT.

(a) In General.--Section 1853(c)(1)(B)(ii) of the Social Security
Act (42 U.S.C. 1395w-23(c)(1)(B)(ii)) is amended--
(1) by striking ''(ii) For a succeeding year'' and
inserting ''(ii)(I) Subject to subclause (II), for a succeeding
year''; and
(2) by adding at the end the following new subclause:
''(II) For 2002 for any of the 50 States
and the District of Columbia, $500.''.
(b) Effective Date.--The amendments made by subsection (a) apply to
years beginning with 2002.

SEC. 4. ALLOWING MOVEMENT TO 50:50 PERCENT BLEND IN 2002.

Section 1853(c)(2) of the Social Security Act (42 U.S.C. 1395w-
23(c)(2)) is amended--
(1) by striking the period at the end of subparagraph (F)
and inserting a semicolon; and
(2) by adding at the end the following flush matter:
''except that a Medicare+Choice organization may elect to apply
subparagraph (F) (rather than subparagraph (E)) for 2002.''.

SEC. 5. INCREASED UPDATE FOR PAYMENT AREAS WITH ONLY ONE OR NO
MEDICARE+CHOICE CONTRACTS.

(a) In General.--Section 1853(c)(1)(C)(ii) of the Social Security
Act (42 U.S.C. 1395w-23(c)(1)(C)(ii)) is amended--
(1) by striking ''(ii) For a subsequent year'' and
inserting ''(ii)(I) Subject to subclause (II), for a subsequent
year''; and
(2) by adding at the end the following new subclause:
''(II) During 2002, 2003, 2004, and 2005,
in the case of a Medicare+Choice payment area
in which there is no more than one contract
entered into under this part as of July 1
before the beginning of the year, 102.5 percent
of the annual Medicare+Choice capitation rate
under this paragraph for the area for the
previous year.''.
(b) Construction.--The amendments made by subsection (a) do not
affect the payment of a first time bonus under section 1853(i) of the
Social Security Act (42 U.S.C. 1395w-23(i)).

SEC. 6. PERMITTING HIGHER NEGOTIATED RATES IN CERTAIN MEDICARE+CHOICE
PAYMENT AREAS BELOW NATIONAL AVERAGE.

Section 1853(c)(1) of the Social Security Act (42 U.S.C. 1395w-
23(c)(1)) is amended--
(1) in the matter preceding subparagraph (A), by striking
''or (C)'' and inserting ''(C), or (D)''; and
(2) by adding at the end the following new subparagraph:
''(D) Permitting higher rates through
negotiation.--
''(i) In general.--For each year beginning
with 2001, in the case of a Medicare+Choice
payment area for which the Medicare+Choice
capitation rate under this paragraph would
otherwise be less than the United States per
capita cost (USPCC), as calculated by the
Secretary, a Medicare+Choice organization may
negotiate with the Secretary an annual per
capita rate that--
''(I) reflects an annual rate of
increase up to the rate of increase
specified in clause (ii);
''(II) takes into account audited
current data supplied by the
organization on its adjusted community
rate (as defined in section
1854(f)(3)); and
''(III) does not exceed the United
States per capita cost, as projected by
the Secretary for the year involved.
''(ii) Maximum rate described.--The rate of
increase specified in this clause for a year is
the rate of inflation in private health
insurance for the year involved, as projected
by the Secretary, and includes such adjustments
as may be necessary--
''(I) to reflect the demographic
characteristics in the population under
this title; and
''(II) to eliminate the costs of
prescription drugs.
''(iii) Adjustments for over or under
projections.--If this subparagraph is applied
to an organization and payment area for a year,
in applying this subparagraph for a subsequent
year the provisions of paragraph (6)(C) shall
apply in the same manner as such provisions
apply under this paragraph.
''(iv) Deadline for completion of
negotiations.--The Secretary shall complete
negotiations with a Medicare+Choice
organization under clause (i) for a year by not
later than 90 days after the date the
organization entered into negotiations with the
Secretary.''.

SEC. 7. 10-YEAR PHASE-IN OF RISK ADJUSTMENT BASED ON DATA FROM ALL
SETTINGS.

Section 1853(a)(3)(C)(ii) of the Social Security Act (42 U.S.C.
1395w-23(c)(1)(C)(ii)) is amended--
(1) by striking the period at the end of subclause (II) and
inserting a semicolon; and
(2) by adding at the end the following flush matter:
''and, beginning in 2004, insofar as such risk
adjustment is based on data from all settings,
the methodology shall be phased-in in equal
increments over a 10-year period, beginning
with 2004 or (if later) the first year in which
such data is used.''.

SEC. 8. DELAY FROM JULY TO NOVEMBER 2000 IN DEADLINE FOR OFFERING AND
WITHDRAWING MEDICARE+CHOICE PLANS FOR 2001.

Notwithstanding any other provision of law, the deadline for a
Medicare+Choice organization to withdraw the offering of a
Medicare+Choice plan under part C of title XVIII of the Social Security
Act (or otherwise to submit information required for the offering of
such a plan) for 2001 is delayed from July 1, 2000, to November 1,
2000, and any such organization that provided notice of withdrawal of
such a plan during 2000 before the date of enactment of this Act may
rescind such withdrawal at any time before November 1, 2000.
Delays from July to November 2000 the deadline for withdrawing the offer, or rescinding the withdrawal, of Medicare+Choice plans for 2001.