Page:United States Statutes at Large Volume 111 Part 1.djvu/330

 Ill STAT. 306 PUBLIC LAW 105-33 —AUG. 5, 1997 consolidated area within the State, are treated as a single Medicare+Choice payment area, sind "(ii) all areas in the State that do not fall within a metropolitan statistical area are treated as a single Medicare+Choice payment area. "(D) AREAS.— In subparagraph (C), the terms 'metropolitan statistical area', 'consolidated metropolitan statistical area', and 'primary metropolitan statistical area' mean any area designated as such by the Secretary of Commerce. " (e) SPECIAL RULES FOR INDIVIDUALS ELECTING MSA PLANS. — "(1) IN GENERAL.— I f the amount of the Medicare+Choice monthly MSA premium (as defined in section 1854(b)(2)(C)) for an MSA plan for a year is less thgin Vi2 of the annual Medicare+Choice capitation rate applied under this section for the area and year involved, the Secretary shall deposit an amount equal to 100 percent of such difference in a Medicare+Choice MSA established (and, if applicable, designated) by the individual under paragraph (2). " (2) ESTABLISHMENT AND DESIGNATION OF MEDICARE+CHOICE MEDICAL SAVINGS ACCOUNT AS REQUIREMENT FOR PAYMENT OF CONTRIBUTION.— In the case of an individual who has elected coverage under an MSA plan, no payment shall be made under paragraph (1) on behalf of an individual for a month unless the individual— "(A) has established before the beginning of the month (or by such other deadline as the Secretary may specify) a Medicare+Choice MSA (as defined in section 138(b)(2) of the Internal Revenue Code of 1986), and "(B) if the individual has established more than one such Medicare+Choice MSA, has designated one of such accounts as the individual's Medicare+Choice MSA for purposes of this part. Under rules under this section, such an individual may change the designation of such account under subparagraph (B) for purposes of this part. " (3) LUMP-SUM DEPOSIT OF MEDICAL SAVINGS ACCOUNT CON- TRIBUTION.— In the case of an individual electing an MSA plan effective beginning with a month in a year, the amount of the contribution to the Medicare+Choice MSA on behalf of the individual for that month and all successive months in the year shall be deposited during that first month. In the case of a termination of such an election as of a month before the end of a year, the Secretary shall provide for a procedure for the recovery of deposits attributable to the remaining months in the year. "(f) PAYMENTS FROM TRUST FUND. —The payment to a Medicare+Choice organization under this section for individuals enrolled under this part with the organization and payments to a Medicare+Choice MSA under subsection (e)(1) shall be made from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurgince Trust Fund in such proportion as the Secretary determines reflects the relative weight that benefits under part A and under part B represents of the actuarial value of the total benefits under this title. Monthly pa5nnents otherwise payable under this section for October 2000 shall be paid on the first business day of such month. Monthly pa5mients otherwise payable under this section for October 2001 shall be paid on the

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