Page:United States Statutes at Large Volume 117.djvu/2234

 PUBLIC LAW 108–173—DEC. 8, 2003 ‘‘COMPARATIVE

117 STAT. 2215

COST ADJUSTMENT (CCA) PROGRAM

‘‘SEC. 1860C–1. (a) ESTABLISHMENT OF PROGRAM.— ‘‘(1) IN GENERAL.—The Secretary shall establish a program under this section (in this section referred to as the ‘CCA program’) for the application of comparative cost adjustment in CCA areas selected under this section. ‘‘(2) DURATION.—The CCA program shall begin January 1, 2010, and shall extend over a period of 6 years, and end on December 31, 2015. ‘‘(3) REPORT.—Upon the completion of the CCA program, the Secretary shall submit a report to Congress. Such report shall include the following, with respect to both this part and the original medicare fee-for-service program: ‘‘(A) An evaluation of the financial impact of the CCA program. ‘‘(B) An evaluation of changes in access to physicians and other health care providers. ‘‘(C) Beneficiary satisfaction. ‘‘(D) Recommendations regarding any extension or expansion of the CCA program. ‘‘(b) REQUIREMENTS FOR SELECTION OF CCA AREAS.— ‘‘(1) CCA AREA DEFINED.— ‘‘(A) IN GENERAL.—For purposes of this section, the term ‘CCA area’ means an MSA that meets the requirements of paragraph (2) and is selected by the Secretary under subsection (c). ‘‘(B) MSA DEFINED.—For purposes of this section, the term ‘MSA’ means a Metropolitan Statistical Area (or such similar area as the Secretary recognizes). ‘‘(2) REQUIREMENTS FOR CCA AREAS.—The requirements of this paragraph for an MSA to be a CCA area are as follows: ‘‘(A) MA ENROLLMENT REQUIREMENT.—For the reference month (as defined under section 1858(f)(4)(B)) with respect to 2010, at least 25 percent of the total number of MA eligible individuals who reside in the MSA were enrolled in an MA local plan described in section 1851(a)(2)(A)(i). ‘‘(B) 2 PLAN REQUIREMENT.—There will be offered in the MSA during the annual, coordinated election period under section 1851(e)(3)(B) before the beginning of 2010 at least 2 MA local plans described in section 1851(a)(2)(A)(i) (in addition to the fee-for-service program under parts A and B), each offered by a different MA organization and each of which met the minimum enrollment requirements of paragraph (1) of section 1857(b) (as applied without regard to paragraph (3) thereof) as of the reference month. ‘‘(c) SELECTION OF CCA AREAS.— ‘‘(1) GENERAL SELECTION CRITERIA.—The Secretary shall select CCA areas from among those MSAs qualifying under subsection (b) in a manner that— ‘‘(A) seeks to maximize the opportunity to test the application of comparative cost adjustment under this title; ‘‘(B) does not seek to maximize the number of MA eligible individuals who reside in such areas; and

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