Page:United States Statutes at Large Volume 117.djvu/2205

 117 STAT. 2186

PUBLIC LAW 108–173—DEC. 8, 2003 not such a plan offered in each such region in the previous year. Funding under this clause is only available with respect to any individual MA organization for a single year, but may be made available to more than one such organization in the same year. ‘‘(ii) REGIONAL PLANS.—Subject to clause (iii), for an increased amount under subparagraph (C) for an MA regional plan offered in an MA region which did not have any MA regional plan offered in the prior year. ‘‘(iii) LIMITATION ON REGIONAL PLAN FUNDING IN CASE OF NATIONAL PLAN.—In no case shall there be any payment adjustment under subparagraph (C) for a year for which a national payment adjustment is made under subparagraph (B). ‘‘(B) NATIONAL BONUS PAYMENT.—The national bonus payment under this subparagraph shall— ‘‘(i) be available to an MA organization only if the organization offers MA regional plans in every MA region; ‘‘(ii) be available with respect to all MA regional plans of the organization regardless of whether any other MA regional plan is offered in any region; and ‘‘(iii) subject to amounts available under paragraph (5) for a year, be equal to 3 percent of the benchmark amount otherwise applicable for each MA regional plan offered by the organization. ‘‘(C) REGIONAL PAYMENT ADJUSTMENT.— ‘‘(i) IN GENERAL.—The increased amount under this subparagraph for an MA regional plan in an MA region for a year shall be an amount, determined by the Secretary, based on the bid submitted for such plan (or plans) and shall be available to all MA regional plans offered in such region and year. Such amount may be based on the mean, mode, or median, or other measure of such bids and may vary from region to region. The Secretary may not limit the number of plans or bids in a region. ‘‘(ii) MULTI-YEAR FUNDING.— ‘‘(I) IN GENERAL.—Subject to amounts available under paragraph (5), funding under this subparagraph shall be available for a period determined by the Secretary. ‘‘(II) REPORT.—If the Secretary determines that funding will be provided for a second consecutive year with respect to an MA region, the Secretary shall submit to the Congress a report that describes the underlying market dynamics in the region and that includes recommendations concerning changes in the payment methodology otherwise provided for MA regional plans under this part. ‘‘(iii) APPLICATION TO ALL PLANS IN A REGION.— Funding under this subparagraph with respect to an MA region shall be made available with respect to all MA regional plans offered in the region.

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