Page:United States Statutes at Large Volume 117.djvu/2221

 117 STAT. 2202

Deadline.

Deadline.

VerDate 11-MAY-2000

13:59 Aug 30, 2004

PUBLIC LAW 108–173—DEC. 8, 2003

‘‘(ii) reimbursement for premium and cost-sharing reductions for low-income individuals under section 1860D–14(c)(1)(C). ‘‘(E) PAYMENT OF REBATE FOR PLANS WITH BIDS BELOW BENCHMARK.—In the case of a plan for which there are average per capita monthly savings described in section 1854(b)(3)(C) or 1854(b)(4)(C), as the case may be, the amount specified in this subparagraph is the amount of the monthly rebate computed under section 1854(b)(1)(C)(i) for that plan and year (as reduced by the amount of any credit provided under section 1854(b)(1)(C)(iv)). ‘‘(F) ADJUSTMENT FOR INTRA-AREA VARIATIONS.— ‘‘(i) INTRA-REGIONAL VARIATIONS.—In the case of payment with respect to an MA regional plan for an MA region, the Secretary shall also adjust the amounts specified under subparagraphs (B)(i) and (B)(ii) in a manner to take into account variations in MA local payment rates under this part among the different MA local areas included in such region. ‘‘(ii) INTRA-SERVICE AREA VARIATIONS.—In the case of payment with respect to an MA local plan for a service area that covers more than one MA local area, the Secretary shall also adjust the amounts specified under subparagraphs (B)(i) and (B)(ii) in a manner to take into account variations in MA local payment rates under this part among the different MA local areas included in such service area. ‘‘(G) ADJUSTMENT RELATING TO RISK ADJUSTMENT.— The Secretary shall adjust payments with respect to MA plans as necessary to ensure that— ‘‘(i) the sum of— ‘‘(I) the monthly payment made under subparagraph (A)(ii); and ‘‘(II) the MA monthly basic beneficiary premium under section 1854(b)(2)(A); equals ‘‘(ii) the unadjusted MA statutory non-drug monthly bid amount, adjusted in the manner described in subparagraph (C) and, for an MA regional plan, subparagraph (F).’’. (f) CONFORMING CHANGES TO ANNUAL ANNOUNCEMENT PROCESS.—Section 1853(b) (42 U.S.C. 1395w–23(b)(1)) is amended— (1) by amending paragraph (1) to read as follows: ‘‘(1) ANNUAL ANNOUNCEMENTS.— ‘‘(A) FOR 2005.—The Secretary shall determine, and shall announce (in a manner intended to provide notice to interested parties), not later than the second Monday in May of 2004, with respect to each MA payment area, the following: ‘‘(i) MA CAPITATION RATES.—The annual MA capitation rate for each MA payment area for 2005. ‘‘(ii) ADJUSTMENT FACTORS.—The risk and other factors to be used in adjusting such rates under subsection (a)(1)(C) for payments for months in 2005. ‘‘(B) FOR 2006 AND SUBSEQUENT YEARS.—For a year after 2005— ‘‘(i) INITIAL ANNOUNCEMENT.—The Secretary shall determine, and shall announce (in a manner intended

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