Page:United States Statutes at Large Volume 122.djvu/2600

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

12 2 STA T . 2 57 7 PUBLIC LA W 11 0– 275 —J UL Y 15 , 200 8admin i str ati ve a c ti o nast h e M edicare P a y ment A dvisory C ommis - sion determines a p propriate .SEC.169 . M E DPA CS TU D Y A N D R EP O RT ON MED I CARE AD V ANTA G E PAYMENTS. ( a )STUDY . —T he Medicare Payment Advisory Commission (in this section re f erred to as the ‘ ‘Commission ’ ’) sha l l cond u ct a study of the follo w in g: ( 1 ) The correlation b etween— (A) the costs that Medicare Advantage organi z ations with respect to Medicare Advantage plans incur in pro- viding coverage under the plan for items and services cov- ered under the original Medicare fee-for-service program under parts A and B of title XVI II of the Social Security Act , as reflected in plan bids

and (B) county-level spending under such original Medicare fee-for-service program on a per capita basis, as calculated by the Chief Actuary of the Centers for Medicare & Med- icaid Services. The study with respect to the issue described in the preceding sentence shall include differences in correlation statistics by plan type and geographic area. ( 2 ) Based on these results of the study with respect to the issue described in paragraph (1), and other data the Commission determines appropriate— (A) alternate approaches to payment with respect to a Medicare beneficiary enrolled in a Medicare Advantage plan other than through county-level payment area e q uiva- lents. (B) the accuracy and completeness of county-level esti- mates of per capita spending under such original Medicare fee-for-service program (including counties in Puerto R ico), as used to determine the annual Medicare Advantage capi- tation rate under section 1 853 of the Social Security Act ( 4 2 U .S.C. 13 9 5w – 23), and whether such estimates include— (i) e x penditures with respect to Medicare bene- ficiaries at facilities of the D epartment of Veterans Affairs; and (ii) all appropriate administrative expenses, including claims processing. (3) W ays to improve the accuracy and completeness of county-level estimates of per capita spending described in para- graph (2)(B). (b) R EPOR T.— N ot later than March 31, 2 0 10, the Commission shall submit to Congress a report containing the results of the study conducted under subsection (a), together with recommenda- tions for such legislation and administrative action as the Commis- sion determines appropriate.