124 STAT. 491 PUBLIC LAW 111–148—MAR. 23, 2010 coverage from the calculation of the national average monthly bid amount under section 1860D–13(a)(4), and reductions in payments to Medicare Advantage plans under clauses (i) and (ii) of section 1853(a)(1)(B) that are related to administrative expenses (including profits) and performance bonuses for Medicare Advan- tage plans under section 1853(n). Any such rec- ommendation shall not affect the base beneficiary pre- mium percentage specified under 1860D–13(a). ‘‘(v) The proposal shall include recommendations with respect to administrative funding for the Sec- retary to carry out the recommendations contained in the proposal. ‘‘(vi) The proposal shall only include recommenda- tions related to the Medicare program. ‘‘(B) ADDITIONAL CONSIDERATIONS.—In developing and submitting each proposal under this section in a proposal year, the Board shall, to the extent feasible— ‘‘(i) give priority to recommendations that extend Medicare solvency; ‘‘(ii) include recommendations that— ‘‘(I) improve the health care delivery system and health outcomes, including by promoting integrated care, care coordination, prevention and wellness, and quality and efficiency improvement; and ‘‘(II) protect and improve Medicare bene- ficiaries’ access to necessary and evidence-based items and services, including in rural and frontier areas; ‘‘(iii) include recommendations that target reduc- tions in Medicare program spending to sources of excess cost growth; ‘‘(iv) consider the effects on Medicare beneficiaries of changes in payments to providers of services (as defined in section 1861(u)) and suppliers (as defined in section 1861(d)); ‘‘(v) consider the effects of the recommendations on providers of services and suppliers with actual or projected negative cost margins or payment updates; and ‘‘(vi) consider the unique needs of Medicare bene- ficiaries who are dually eligible for Medicare and the Medicaid program under title XIX. ‘‘(C) NO INCREASE IN TOTAL MEDICARE PROGRAM SPENDING.—Each proposal submitted under this section shall be designed in such a manner that implementation of the recommendations contained in the proposal would not be expected to result, over the 10-year period starting with the implementation year, in any increase in the total amount of net Medicare program spending relative to the total amount of net Medicare program spending that would have occurred absent such implementation. ‘‘(D) CONSULTATION WITH MEDPAC.—The Board shall submit a draft copy of each proposal to be submitted under this section to the Medicare Payment Advisory Commission established under section 1805 for its review. The Board Deadline. Submission.
