Page:United States Statutes at Large Volume 117.djvu/2208

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2189

‘‘(i) the total amount expended as a result of the application of this subsection in the previous year compared to the total amount that would have been expended under this title in the year if this subsection had not been enacted; ‘‘(ii) the projections of the total amount that will be expended as a result of the application of this subsection in the year in which the report is submitted compared to the total amount that would have been expended under this title in the year if this subsection had not been enacted; ‘‘(iii) amounts remaining within the funding limitation specified in paragraph (5); and ‘‘(iv) the steps that the Secretary will take under paragraph (5)(B) to ensure that the application of this subsection will not cause expenditures to exceed the amount available in the Fund; and ‘‘(B) a certification from the Chief Actuary of the Centers for Medicare & Medicaid Services that the description provided under subparagraph (A) is reasonable, accurate, and based on generally accepted actuarial principles and methodologies. ‘‘(7) BIENNIAL GAO REPORTS.—Not later than January 1 of 2009, 2011, 2013, and 2015, the Comptroller General of the United States shall submit to the Secretary and Congress a report on the application of additional payments under this subsection. Each report shall include— ‘‘(A) an evaluation of— ‘‘(i) the quality of care provided to individuals enrolled in MA regional plans for which additional payments were made under this subsection; ‘‘(ii) the satisfaction of such individuals with benefits under such a plan; ‘‘(iii) the costs to the medicare program for payments made to such plans; and ‘‘(iv) any improvements in the delivery of health care services under such a plan; ‘‘(B) a comparative analysis of the performance of MA regional plans receiving payments under this subsection with MA regional plans not receiving such payments; and ‘‘(C) recommendations for such legislation or administrative action as the Comptroller General determines to be appropriate. ‘‘(f) COMPUTATION OF APPLICABLE MA REGION-SPECIFIC NONDRUG MONTHLY BENCHMARK AMOUNTS.— ‘‘(1) COMPUTATION FOR REGIONS.—For purposes of section 1853(j)(2) and this section, subject to subsection (e), the term ‘MA region-specific non-drug monthly benchmark amount’ means, with respect to an MA region for a month in a year, the sum of the 2 components described in paragraph (2) for the region and year. The Secretary shall compute such benchmark amount for each MA region before the beginning of each annual, coordinated election period under section 1851(e)(3)(B) for each year (beginning with 2006). ‘‘(2) 2 COMPONENTS.—For purposes of paragraph (1), the 2 components described in this paragraph for an MA region and a year are the following:

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