Medicare+Choice Risk Adjustment Amendments of 1999

Medicare+Choice Risk Adjustment Amendments of 1999 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to: (1) require that the new risk adjustment methodology for Medicare+Choice payment rates be implemented in a budget neutral manner; and (2) eliminate any further adjustment in the national per capita Medicare+Choice growth percentage.

[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2419 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 2419

  To amend title XVIII of the Social Security Act to reflect original 
    Congressional intent by requiring that the new risk adjustment 
   methodology for Medicare+Choice payment rates be implemented in a 
             budget neutral manner, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 1, 1999

 Mr. Bilirakis (for himself, Mr. Deutsch, Mr. LaTourette, Mr. Tauzin, 
   Ms. Brown of Florida, Mr. Greenwood, Mr. Towns, Mr. McCollum, Mr. 
Canady of Florida, Mr. Gilchrest, Mr. Kolbe, Mr. Bass, Mrs. Fowler, Mr. 
Walden of Oregon, and Mr. Stearns) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to the 
 Committee on 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 reflect original 
    Congressional intent by requiring that the new risk adjustment 
   methodology for Medicare+Choice payment rates be implemented in a 
             budget neutral manner, and for other purposes.

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

SECTION 1. SHORT TITLE; FINDINGS AND PURPOSE.

    (a) Short Title.--This Act may be cited as the ``Medicare+Choice 
Risk Adjustment Amendments of 1999''.
    (b) Findings.--Congress finds as follows:
            (1) The enactment of the Balanced Budget Act of 1997 
        provided for development and implementation of a new, more 
        sophisticated risk adjustment methodology under the 
        Medicare+Choice program, to assure a better match between 
        payment rates for individuals with different risks enrolled in 
        Medicare+Choice plans. This was in addition to changes in the 
        underlying payment system that was designed to provide for 
        savings to the medicare program.
            (2) The Congressional Budget Office did not estimate that 
        this new risk adjustment system would change the overall 
        payment levels for such plans or the participation of such 
        plans in the Medicare+Choice program.
            (3) The Health Care Financing Administration has proposed 
        implementation of a new risk adjustment methodology that not 
        only results in substantial reductions in payments to 
        Medicare+Choice plans beyond those contemplated in the Balanced 
        Budget Act of 1997, but also would result in a decrease in the 
        participation of such plans in the program, directly against 
        the intent of Congress and the projections made at the time of 
        the enactment of that Act.
    (c) Purpose.--It is the purpose of section 2 of this Act to restore 
the original intent of Congress when it required implementation of a 
new risk adjustment methodology for Medicare+Choice payment rates by 
assuring that such methodology is established in a budget neutral 
manner that does not affect overall spending levels under the medicare 
program using the current risk adjustment methodology.

SEC. 2. APPLICATION OF BUDGET NEUTRALITY PRINCIPLE TO THE NEW 
              MEDICARE+CHOICE RISK ADJUSTMENT METHODOLOGY.

    (a) In General.--Section 1853(a)(3) of the Social Security Act (42 
U.S.C. 1395w-23(a)(3)) is amended by adding at the end the following 
new subparagraph:
                    ``(E) Implementation in a budget neutral manner.--
                The methodology under this paragraph shall be designed 
                and implemented in a manner so that it does not result 
                in any material change in the aggregate level of 
                expenditures under this title compared to the level 
                that would have occurred if such methodology had not 
                been implemented (and if the previous risk adjustment 
                methodology had continued to be implemented).''.
    (b) Effective Date.--The amendment made by subsection (a) takes 
effect on the date of the enactment of this Act and applies to payments 
for months beginning on or after January 2000.

SEC. 3. ELIMINATION OF ANY FURTHER ADJUSTMENT IN THE NATIONAL PER 
              CAPITA MEDICARE+CHOICE GROWTH PERCENTAGE.

    Section 1853(c)(6)(B) of the Social Security Act (42 U.S.C. 1395w-
23(c)(6)(B)) is amended--
            (1) by inserting ``and'' at the end of clause (ii);
            (2) by striking clauses (iii) through (v); and
            (3) in clause (vi), by striking ``2002'' and inserting 
        ``1999'' and redesignating such clause as clause (iii).
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