12 2 STA T . 2 576PUBLIC LA W 11 0– 275 —J UL Y 15 , 200 8173),isamend ed by s tr i k in g‘ ‘ J an u ary 1, 20 0 9’ ’ and inserting ‘‘January 1, 2010’’ in t h e matter p re c eding subc l ause (I ) . (b) REQUIR E M E NTFO R A T L EA S T TW O M E D I C ARE A D V ANTA G E O RGANI Z ATIONS TO B E OFFERING A PL ANINANAREAFORT H E PROHI B ITION TO BE A P PLICABLE. —S ubclauses (I) and (II) of section 1 8 7 6 (h)( 5 )( C )(ii) of the Social Security Act ( 4 2 U .S.C. 1395mm(h)(5)(C)(ii)) are each amended by inserting ‘‘, pro v ided that all such plans are not offered by the same Medicare Advantage organi z ation’’ after ‘‘clause (iii)’’. (c) REVISION OF REQUIREMENTS FOR A PLAN THAT ARE USED TO D ETERMINE IF PROHIBITION IS APPLICABLE.— (1) IN GENERAL.—Section 1876(h)(5)(C)(iii)(I) of the Social Security Act (42 U.S.C. 1395mm(h)(5)(C)(iii)(I)) is amended by inserting ‘‘that are not in another Metropolitan Statistical Area w ith a population of more than 250,000’’ after ‘‘such Metropoli - tan Statistical Area’’. (2) CLARIFICATION.—Section 1876(h)(5)(C)(iii)(I) of the Social Security Act (42 U.S.C. 1395mm(h)(5)(C)(iii)(I)) is amended by adding at the end the following new sentence
‘‘If the service area includes a portion in more than 1 Metropoli- tan Statistical Area with a population of more than 250,000, the minimum enrollment determination under the preceding sentence shall be made with respect to each such Metropolitan Statistical Area (and such applicable contiguous counties to such Metropolitan Statistical Area).’’. (d) G AO STUD Y AND REPORT.— (1) STUDY.—The Comptroller General of the United States shall conduct a study of the reasons (if any) why reasonable cost contracts under section 1876(h) of the Social Security Act (42 U.S.C. 1395mm(h)) are unable to become Medicare Advan- tage plans under part C of title XV III of such Act. (2) REPORT.— N ot later than December 31, 2009, the Comp- troller General of the United States shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations for such legisla- tion and administrative action as the Comptroller General determines appropriate. SEC.168 . M E DPA CS TU D Y A N D R EP O RT ON Q UA LI TY MEASURES. (a) STUDY.—The Medicare Payment Advisory Commission shall conduct a study on how comparable measures of performance and patient e x perience can be collected and reported by 2011 for the Medicare Advantage program under part C of title XVIII of the Social Security Act and the original Medicare fee-for-service pro- gram under parts A and B of such title. Such study shall address technical issues, such as data re q uirements, in addition to issues relating to appropriate quality benchmarks that— (1) compare the quality of care Medicare beneficiaries receive across Medicare Advantage plans
and (2) compare the quality of care Medicare beneficiaries receive under Medicare Advantage plans and under the original Medicare fee-for-service program. (b) REPORT.—Not later than March 31, 2010, the Medicare Payment Advisory Commission shall submit to Congress a report containing the results of the study conducted under subsection (a), together with recommendations for such legislation and
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