Page:United States Statutes at Large Volume 117.djvu/2196

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2177

‘‘(iii) INCLUSION

OF COSTS OF VA AND DOD MILITARY BENESERVICES TO MEDICARE-ELIGIBLE

FACILITY FICIARIES.—In

determining the adjusted average per capita cost under clause (i) for a year, such cost shall be adjusted to include the Secretary’s estimate, on a per capita basis, of the amount of additional payments that would have been made in the area involved under this title if individuals entitled to benefits under this title had not received services from facilities of the Department of Defense or the Department of Veterans Affairs.’’. (2) CONFORMING AMENDMENT.—Such section is further amended, in the matter before subparagraph (A), by striking ‘‘or (C)’’ and inserting ‘‘(C), or (D)’’. (b) CHANGE IN BUDGET NEUTRALITY FOR BLEND.—Section 1853(c) (42 U.S.C. 1395w–23(c)) is amended— (1) in paragraph (1)(A), by inserting ‘‘(for a year other than 2004)’’ after ‘‘multiplied’’; and (2) in paragraph (5), by inserting ‘‘(other than 2004)’’ after ‘‘for each year’’. (c) INCREASING MINIMUM PERCENTAGE INCREASE TO NATIONAL GROWTH RATE.— (1) IN GENERAL.—Section 1853(c)(1) (42 U.S.C. 1395w– 23(c)(1)) is amended— (A) in subparagraph (A), by striking ‘‘The sum’’ and inserting ‘‘For a year before 2005, the sum’’; (B) in subparagraph (B)(iv), by striking ‘‘and each succeeding year’’ and inserting ‘‘, 2003, and 2004’’; (C) in subparagraph (C)(iv), by striking ‘‘and each succeeding year’’ and inserting ‘‘and 2003’’; and (D) by adding at the end of subparagraph (C) the following new clause: ‘‘(v) For 2004 and each succeeding year, the greater of— ‘‘(I) 102 percent of the annual MA capitation rate under this paragraph for the area for the previous year; or ‘‘(II) the annual MA capitation rate under this paragraph for the area for the previous year increased by the national per capita MA growth percentage, described in paragraph (6) for that succeeding year, but not taking into account any adjustment under paragraph (6)(C) for a year before 2004.’’. (2) CONFORMING AMENDMENT.—Section 1853(c)(6)(C) (42 U.S.C. 1395w–23(c)(6)(C)) is amended by inserting before the period at the end the following: ‘‘, except that for purposes of paragraph (1)(C)(v)(II), no such adjustment shall be made for a year before 2004’’. (d) INCLUSION OF COSTS OF DOD AND VA MILITARY FACILITY SERVICES TO MEDICARE-ELIGIBLE BENEFICIARIES IN CALCULATION OF PAYMENT RATES.—Section 1853(c)(3) (42 U.S.C. 1395w–23(c)(3)) is amended— (1) in subparagraph (A), by striking ‘‘subparagraph (B)’’ and inserting ‘‘subparagraphs (B) and (E)’’; and (2) by adding at the end the following new subparagraph:

VerDate 11-MAY-2000

13:59 Aug 30, 2004

Jkt 019194

PO 00000

Frm 00113

Fmt 6580

Sfmt 6581

D:\STATUTES\2003\19194PT3.001

APPS10

PsN: 19194PT3

�