113 STAT. 1501A-380 PUBLIC LAW 106-113—APPENDIX F SEC. 502. CHANGE IN EFFECTIVE DATE OF ELECTIONS AND CHANGES OF ELECTIONS OF MEDICARE+CHOICE PLANS. (a) OPEN ENROLLMENT.— Section 1851(f)(2) (42 U.S.C. 1395w- 21(f)(2)) is amended— (1) by inserting "or change" before "is made"; and (2) by inserting ", except that if such election or change is made after the 10th day of any calendar month, then the election or change shall not take effect until the first day of the second calendar month following the date on which the election or change is made" before the period. (b) EFFECTIVE DATE. —The amendments made by this section apply to elections and changes of coverage made on or after January 1, 2000. SEC. 503. 2 -YEAR EXTENSION OF MEDICARE COST CONTRACTS. Section 1876(h)(5)(B) (42 U.S.C. 1395mm(h)(5)(B)) is amended by striking "2002" and inserting "2004". Subtitle B—Provisions To Facilitate Implementation of the Medicare+Choice Program SEC. 511. PHASE-IN OF NEW RISK ADJUSTMENT METHODOLOGY; STUDIES AND REPORTS ON RISK ADJUSTMENT. (a) PHASE-IN.— Section 1853(a)(3)(C) (42 U.S.C. 1395w- 23(a)(3)(C)) is amended— (1) by redesignating the first sentence as clause (i) with the heading "IN GENERAL. —" and appropriate indentation; and (2) by adding at the end the following new clause: " (ii) PHASE-IN. —Such risk adjustment methodology shall be implemented in a phased-in manner so that the methodology insofar as it makes adjustments to capitation rates for health status applies to— "(I) 10 percent of yi2 of the annual Medicare+Choice capitation rate in 2000 and 2001; and "(II) not more than 20 percent of such capitation rate in 2002.". (b) MEDPAC STUDY AND REPORT.— (1) STUDY.— The Medicare Payment Advisory Commission shall conduct a study that evaluates the methodology used by the Secretary of Health and Human Services in developing the risk factors used in adjusting the Medicare+Choice capitation rate paid to Medicare+Choice organizations under section 1853 of the Social Security Act (42 U.S.C. 1395w-23) and includes the issues described in paragraph (2). (2) ISSUES TO BE STUDIED.—The issues described in this paragraph are the following: (A) The ability of the average risk adjustment factor applied to a Medicare+Choice plan to explain variations I in plans' average per capita medicare costs, as reported by Medicare+Choice plans in the plans' adjusted community rate filings. (B) The year-to-year stability of the risk factors applied to each Medicare+Choice plan and the potential for
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