124 STAT. 458 PUBLIC LAW 111–148—MAR. 23, 2010 for a limited period of time for individuals enrolled under a specialized MA plan for special needs individuals described in subsection (b)(6)(B)(ii) who are no longer eligible for medical assistance under title XIX. ‘‘(D) TIMELINE FOR INITIAL TRANSITION.—The Secretary shall ensure that applicable individuals enrolled in a specialized MA plan for special needs individuals (as defined in subsection (b)(6)) prior to January 1, 2010, are transitioned to a plan or the program described in subpara- graph (A) by not later than January 1, 2013.’’. (d) TEMPORARY EXTENSION OF AUTHORITY TO OPERATE BUT NO SERVICE AREA EXPANSION FOR DUAL SPECIAL NEEDS PLANS THAT DO NOT MEET CERTAIN REQUIREMENTS.—Section 164(c)(2) of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110–275) is amended by striking ‘‘December 31, 2010’’ and inserting ‘‘December 31, 2012’’. (e) AUTHORITY TO REQUIRE SPECIAL NEEDS PLANS BE NCQA APPROVED.—Section 1859(f) of the Social Security Act (42 U.S.C. 1395w–28(f)), as amended by subsections (a) and (c), is amended— (1) in paragraph (2), by adding at the end the following new subparagraph: ‘‘(C) If applicable, the plan meets the requirement described in paragraph (7).’’; (2) in paragraph (3), by adding at the end the following new subparagraph: ‘‘(E) If applicable, the plan meets the requirement described in paragraph (7).’’; (3) in paragraph (4), by adding at the end the following new subparagraph: ‘‘(C) If applicable, the plan meets the requirement described in paragraph (7).’’; and (4) by adding at the end the following new paragraph: ‘‘(7) AUTHORITY TO REQUIRE SPECIAL NEEDS PLANS BE NCQA APPROVED.—For 2012 and subsequent years, the Secretary shall require that a Medicare Advantage organization offering a specialized MA plan for special needs individuals be approved by the National Committee for Quality Assurance (based on standards established by the Secretary).’’. (f) RISK ADJUSTMENT.—Section 1853(a)(1)(C) of the Social Secu- rity Act (42 U.S.C. 1395i–23(a)(1)(C)) is amended by adding at the end the following new clause: ‘‘(iii) IMPROVEMENTS TO RISK ADJUSTMENT FOR SPE- CIAL NEEDS INDIVIDUALS WITH CHRONIC HEALTH CONDI- TIONS.— ‘‘(I) IN GENERAL.—For 2011 and subsequent years, for purposes of the adjustment under clause (i) with respect to individuals described in sub- clause (II), the Secretary shall use a risk score that reflects the known underlying risk profile and chronic health status of similar individuals. Such risk score shall be used instead of the default risk score for new enrollees in Medicare Advantage plans that are not specialized MA plans for special needs individuals (as defined in section 1859(b)(6)). ‘‘(II) INDIVIDUALS DESCRIBED.—An individual described in this subclause is a special needs indi- vidual described in subsection (b)(6)(B)(iii) who 42 USC 1395w–23. Standards. 42 USC 1395w–28 note. Deadline.
