H. R. 4254
IN THE HOUSE OF REPRESENTATIVES
March 22, 2012
Mr. Stark introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To amend title XVIII of the Social Security Act to enhance Medicare Advantage program integrity.
This Act may be cited as the
Medicare Advantage Program Integrity
Act of 2012.
Medicare Advantage coding intensity adjustment
Section 1853(a)(1)(C)(ii)(III) of the Social Security Act (42 U.S.C. 1395w–23(a)(1)(C)(ii)(III)) is amended to read as follows:
In calculating each year’s adjustment, the adjustment factor shall be for 2014, not less than the adjustment factor applied for 2010, plus 1.3 percentage points; for each of years 2015 through 2018, not less than the adjustment factor applied for the previous year, plus 0.6 percentage point; and for 2019 and each subsequent year, not less than 7.1 percent.
Implementation of Office of Inspector General recommendation to delay certain Medicare plan prepayments
Medicare Advantage payments
Section 1853(a)(1) of the Social Security Act (42 U.S.C. 1395w–23(a)(1)) is amended—
in subparagraph (A), in the matter preceding clause (i)—
subsections (e), (g), (i), and (l) and inserting
subparagraph (I), subsections (e), (g), (i), and (l),;
(or, for months beginning with January 2013, on the date specified in
subparagraph (I)) after
in advance; and
by adding at the end the following new subparagraph:
Timing of payments
With respect to monthly payments under this section for months beginning with January 2013, subject to clause (ii), the date specified in this subparagraph with respect to a payment for—
January is January 2nd;
February is February 15th;
March is March 30th; and
April or any succeeding month in a year is the 15th day of the 2nd succeeding month.
Holidays, weekends, etc
If the date otherwise specified in clause (i) is a holiday or weekend, the date specified in this subparagraph shall be the first weekday before such date.
Application under part D
Section 1860D–15(d)(1) of the Social Security Act
(42 U.S.C. 1395w–115(d)(1)) is amended by inserting
and shall be made
consistent with the timing of monthly payments to MA organizations under
section 1853(a)(1)(I) after
as the Secretary