Page:United States Statutes at Large Volume 117.djvu/2218

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2199

in the previous year, the Secretary shall estimate such average. In making such estimate, the Secretary may use average risk adjustment factors applied to comparable regions or applied on a national basis. ‘‘(iii) AUTHORITY TO DETERMINE RISK ADJUSTMENT FOR AREAS OTHER THAN REGIONS.—The Secretary may provide for the determination and application of risk adjustment factors under this subparagraph on the basis of areas other than MA regions or on a planspecific basis. ‘‘(B) DETERMINATION OF RISK-ADJUSTED BENCHMARK AND RISK-ADJUSTED BID FOR REGIONAL PLANS.—For each MA regional plan offered in a region, the Secretary shall— ‘‘(i) adjust the applicable MA area-specific nondrug monthly benchmark amount (as defined in section 1853(j)(2)) for the region by the average risk adjustment factor computed under subparagraph (A); and ‘‘(ii) adjust the unadjusted MA statutory non-drug monthly bid amount by such applicable average risk adjustment factor. ‘‘(C) DETERMINATION OF AVERAGE PER CAPITA MONTHLY SAVINGS.—The average per capita monthly savings described in this subparagraph for an MA regional plan is equal to the amount (if any) by which— ‘‘(i) the risk-adjusted benchmark amount computed under subparagraph (B)(i); exceeds ‘‘(ii) the risk-adjusted bid computed under subparagraph (B)(ii).’’. (c) COLLECTION OF PREMIUMS.—Section 1854(d) (42 U.S.C. 1395w–24(d)) is amended— (1) by striking ‘‘PREMIUMS.—Each’’ and inserting ‘‘PREMIUMS.— ‘‘(1) IN GENERAL.—Each’’; and (2) by adding at the end the following new paragraphs: ‘‘(2) BENEFICIARY’S OPTION OF PAYMENT THROUGH WITHHOLDING FROM SOCIAL SECURITY PAYMENT OR USE OF ELECTRONIC FUNDS TRANSFER MECHANISM.—In accordance with regulations, an MA organization shall permit each enrollee, at the enrollee’s option, to make payment of premiums (if any) under this part to the organization through— ‘‘(A) withholding from benefit payments in the manner provided under section 1840 with respect to monthly premiums under section 1839; ‘‘(B) an electronic funds transfer mechanism (such as automatic charges of an account at a financial institution or a credit or debit card account); or ‘‘(C) such other means as the Secretary may specify, including payment by an employer or under employmentbased retiree health coverage (as defined in section 1860D– 22(c)(1)) on behalf of an employee or former employee (or dependent). All premium payments that are withheld under subparagraph (A) shall be credited to the appropriate Trust Fund (or Account thereof), as specified by the Secretary, under this title and shall be paid to the MA organization involved. No charge may be imposed under an MA plan with respect to the election

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