124 STAT. 452 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(II) the applicable amount (as so defined) for the MA local plan for the year. ‘‘(B) REQUIREMENT TO SUBMIT BIDS UNDER COMPETITIVE BIDDING.—The Medicare Advantage organization shall submit a single bid amount under section 1854(a) for the MA local plan. The Medicare Advantage organization shall remove from such bid amount any effects of induced demand for care that may result from the higher rebates available to grandfathered enrollees under this subsection. ‘‘(C) NONAPPLICATION OF BONUS PAYMENTS AND ANY OTHER REBATES.—The Medicare Advantage organization offering the MA local plan shall not be eligible for any bonus payment under subsection (n) or any rebate under this part (other than as provided under this subsection) with respect to grandfathered enrollees. ‘‘(D) NONAPPLICATION OF UNIFORM BID AND PREMIUM AMOUNTS TO GRANDFATHERED ENROLLEES.—Section 1854(c) shall not apply with respect to the MA local plan. ‘‘(E) NONAPPLICATION OF LIMITATION ON APPLICATION OF PLAN REBATES TOWARD PAYMENT OF PART B PREMIUM.— Notwithstanding clause (iii) of section 1854(b)(1)(C), in the case of a grandfathered enrollee, a rebate under such sec- tion may be used for the purpose described in clause (ii)(III) of such section. ‘‘(F) RISK ADJUSTMENT.—The Secretary shall risk adjust rebates to grandfathered enrollees under this sub- section in the same manner as the Secretary risk adjusts beneficiary rebates described in section 1854(b)(1)(C). ‘‘(4) DEFINITION OF GRANDFATHERED ENROLLEE.—In this subsection, the term ‘grandfathered enrollee’ means an indi- vidual who is enrolled (effective as of the date of enactment of this subsection) in an MA local plan in an area that is identified by the Secretary under paragraph (1).’’. (h) TRANSITIONAL EXTRA BENEFITS.—Section 1853 of the Social Security Act (42 U.S.C. 1395w–23), as amended by subsections (f) and (g), is amended by adding at the end the following new subsection: ‘‘(p) TRANSITIONAL EXTRA BENEFITS.— ‘‘(1) IN GENERAL.—For years beginning with 2012, the Sec- retary shall provide transitional rebates under section 1854(b)(1)(C) for the provision of extra benefits (as specified by the Secretary) to enrollees described in paragraph (2). ‘‘(2) ENROLLEES DESCRIBED.—An enrollee described in this paragraph is an individual who— ‘‘(A) enrolls in an MA local plan in an applicable area; and ‘‘(B) experiences a significant reduction in extra bene- fits described in clause (ii) of section 1854(b)(1)(C) as a result of competitive bidding under this part (as determined by the Secretary). ‘‘(3) APPLICABLE AREAS.—In this subsection, the term ‘applicable area’ means the following: ‘‘(A) The 2 largest metropolitan statistical areas, if the Secretary determines that the total amount of such extra benefits for each enrollee for the month in those areas is greater than $100. ‘‘(B) A county where— Definition. Effective date.
