Affordability in Medicare Premiums Act of 2005 - Directs the Secretary of Health and Human Services, for each year beginning with 2006, to reduce the monthly Medicare part B (Supplementary Medical Insurance) premium rate for each month in the year for individuals not enrolled in a Medicare Advantage plan so that the aggregate amount of such reductions in the year equals an amount computed according to a specified formula involving reduced payments to Medicare Advantage organizations.
Requires the Secretary, in applying risk adjustment factors to payments to Medicare Advantage organizations, to ensure that such payments are adjusted to reflect the enrollee's health status, including adjusting for the difference between the health status of the enrollee and individuals enrolled under the original Medicare fee-for-service program under Medicare parts A (Hospital Insurance) and B. Requires payments to such organizations, in the aggregate, to reflect such differences.
Eliminates the MA Regional Plan Stabilization Fund (Slush Fund).
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1589 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 1589
To amend title XVIII of the Social Security Act to provide for
reductions in the medicare part B premium through elimination of
certain overpayments to Medicare Advantage organizations.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 29, 2005
Mr. Bingaman (for himself, Mr. Rockefeller, Mr. Feingold, Mr. Corzine,
Mr. Kohl, Ms. Mikulski, Mr. Durbin, and Mr. Harkin) introduced the
following bill; which was read twice and referred to the Committee on
Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for
reductions in the medicare part B premium through elimination of
certain overpayments to Medicare Advantage organizations.
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 ``Affordability in Medicare Premiums
Act of 2005''.
SEC. 2. REDUCTION OF MEDICARE PART B PREMIUM FOR INDIVIDUALS NOT
ENROLLED IN A MEDICARE ADVANTAGE PLAN.
Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)) is
amended--
(1) in paragraph (3), in the first sentence, by striking
``The Secretary'' and inserting ``Subject to paragraph (5), the
Secretary''; and
(2) by adding at the end the following new paragraph:
``(5)(A) For each year (beginning with 2006), the Secretary shall
reduce the monthly premium rate determined under paragraph (3) for each
month in the year for individuals who are not enrolled in a Medicare
Advantage plan (including such individuals subject to an increased
premium under subsection (b) or (i)) so that the aggregate amount of
such reductions in the year is equal to the aggregate amount of reduced
expenditures from the Federal Supplementary Medicare Insurance Trust
Fund that the Secretary estimates would result in the year if the
annual Medicare+Choice capitation rate for the year was equal to the
amount specified under subparagraph (D) of section 1853(c)(1), and not
subparagraph (A), (B), or (C) of such section.
``(B) In order to carry out subsections (a)(1) and (b)(1) of
section 1840, the Secretary shall transmit to the Commissioner of
Social Security and the Railroad Retirement Board by the beginning of
each year (beginning with 2006), such information determined
appropriate by the Secretary, in consultation with the Commissioner of
Social Security and the Railroad Retirement Board, regarding the amount
of the monthly premium rate determined under paragraph (3) for
individuals after the application of subparagraph (A).''.
SEC. 3. FUNDING REDUCTIONS IN THE MEDICARE PART B PREMIUM THROUGH
REDUCTIONS IN PAYMENTS TO MEDICARE ADVANTAGE
ORGANIZATIONS.
Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)), as
amended by section 2, is amended--
(1) in paragraph (3), in the first sentence, by striking
``paragraph (5)'' and inserting ``paragraphs (5) and (6)''; and
(2) by adding at the end the following new paragraph:
``(6) For each year (beginning with 2006), the Secretary shall
reduce the monthly premium rate determined under paragraph (3) for each
month in the year for each individual enrolled under this part
(including such an individual subject to an increased premium under
subsection (b) or (i)) so that the aggregate amount of such reductions
in the year is equal to an amount equal to--
``(A) the aggregate amount of reduced expenditures from the
Federal Supplementary Medicare Insurance Trust Fund in the year
that the Secretary estimates will result from the provisions
of, and the amendments made by, sections 4 and 5 of the
Affordability in Medicare Premiums Act of 2005; minus
``(B) the aggregate amount of reductions in the monthly
premium rate in the year pursuant to paragraph (5)(A).''.
SEC. 4. APPLICATION OF RISK ADJUSTMENT REFLECTING CHARACTERISTICS FOR
THE ENTIRE MEDICARE POPULATION IN PAYMENTS TO MEDICARE
ADVANTAGE ORGANIZATIONS.
Effective January 1, 2006, in applying risk adjustment factors to
payments to organizations under section 1853 of the Social Security Act
(42 U.S.C. 1395w-23), the Secretary of Health and Human Services shall
ensure that payments to such organizations are adjusted based on such
factors to ensure that the health status of the enrollee is reflected
in such adjusted payments, including adjusting for the difference
between the health status of the enrollee and individuals enrolled
under the original medicare fee-for-service program under parts A and B
of title XVIII of such Act. Payments to such organizations must, in
aggregate, reflect such differences.
SEC. 5. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND (SLUSH
FUND).
(a) In General.--Subsection (e) of section 1858 of the Social
Security Act (42 U.S.C. 1395w-27a) is repealed.
(b) Conforming Amendment.--Section 1858(f)(1) of the Social
Security Act (42 U.S.C. 1395w-27a(f)(1)) is amended by striking
``subject to subsection (e),''.
(c) Effective Date.--The amendments made by this section shall take
effect as if included in the enactment of section 221(c) of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003
(Public Law 108-173; 117 Stat. 2181).
<all>
Introduced in Senate
Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S9510)
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line