Page:United States Statutes at Large Volume 122.djvu/2592

 12 2 STA T . 2 569PUBLIC LA W 11 0– 2 7 5 —J UL Y 15, 200 8they e ar.An ya djus t m ent under the p re c ed i n g sentence sha l l b e made pri o r to the application o f paragraph (2) . ‘ ‘( B ) PERC E NTAG E SD E FI NED. —F or purposes of this paragraph

‘‘(i) P H ASE - IN P ERCENTAGE.— T he term ‘phase-in percentage ’ means , for an area for a year, the ratio (e x pressed as a percentage, but in no case greater than 10 0 percent) of— ‘‘( I ) the maximum cumulati v e adjustment percentage for the year (as defined in clause (ii)) to ‘‘(II) the standardi z edI ME cost percentage (as defined in clause (iii)) for the area and year. ‘‘(ii) MA X I MU M CUMU L ATI V EAD J USTMENT PERCENT- AGE.—The term ‘maximum cumulative adjustment percentage’ means, for— ‘‘(I) 2010, 0. 6 0 percent; and ‘‘(II) a subse q uent year, the maximum cumu- lative adjustment percentage for the previous year increased by 0.60 percentage points. ‘‘(iii) S TANDARDI Z EDIMEC O ST PERCENTAGE.—The term ‘standardized IME cost percentage’ means, for an area for a year, the per capita costs for payments under section 1 8 86(d)( 5 )(B) (expressed as a percentage of the fee-for-service amount specified in subparagraph ( C )) for the area and the year. ‘‘(C) FEE-FOR-SERVICE AMOUNT.—The fee-for-service amount specified in this subparagraph for an area for a year is the amount specified under subsection (c)(1)( D ) for the area and the year.’’. (b) EXCLUDING ADJUSTMENT FROM THE U PDATE.—Section 185 3 ( k )(1)(B)(i) of the Social Security Act ( 4 2 U.S.C. 13 9 5 w– 23(k)(1)(B)(i)) is amended by striking ‘‘paragraph (2)’’ and inserting ‘‘paragraphs (2) and (4)’’. (c) H OLD HARMLESS FOR PACE PROGRAM PA Y MENTS.—Section 1894(d) of the Social Security Act (42 U.S.C. 1395eee(d)) is amended by adding at the end the following new paragraph: ‘‘(3) CAPITATION RATES DETERMINED W ITHOUT REGARD TO THE PHASE-OUT OF THE INDIRECT COSTS OF MEDICAL EDUCATION FROM THE ANNUAL MEDICARE ADVANTAGE CAPITATION RATE.— Capitation amounts under this subsection shall be determined without regard to the application of section 1853(k)(4).’’. SEC.162 . R E VI SI ON S T ORE QU IRE M ENTS F OR ME D IC A RE ADVANTA G E P RIVATE FEE - FOR-SERVICE P L ANS. (a) R E Q UIREMENTS TO ASSURE ACCESS TO N ETWOR K COV- ERAGE.— (1) INDIVIDUAL MARKET.—Section 1852(d) of the Social Security Act (42 U.S.C. 1395w–22(d)) is amended— (A) in paragraph (4), in the second sentence, by striking ‘‘The Secretary’’ and inserting ‘‘Subject to paragraph (5), the Secretary’’; and (B) by adding at the end the following new paragraph: ‘‘(5) REQUIREMENT OF CERTAIN NONEMPLOYER MEDICARE ADVANTAGE PRIVATE FEE-FOR-SERVICE PLANS TO USE CONTRACTS WITH PROVIDERS.—

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