#aad? ,,congress  #a/ ,session  ,h4 ,r4 
#bejg  ,,an ,,act  ,to am5d title       
,,xviii ( ! ,social ,security ,act to   
e/abli% an annual rulemak+ s*$ule =     
paym5t rates "u ,m$ic>e ,advantage4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,increas+ ,regulatory ,fairness ,act (  
#bjae4  #b4 ,e/abli%+ an annual rulemak+
 s*$ule = paym5t rates "u ,m$ic>e       
,advantage ,section #ahec7;b7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#bc7;b77 is am5d$--  7#a7 9 !    
subsection head+1 by ins]t+ 1 annual    
rulemak+ s*$ule = paym5t rates = #bjag &
 subsequ5t ye>s aft] ,rates2  7#b7 9    
p>agraph 7#a7--  7,a7 9 subp>agraph     
7,b7-- 7i7 9 ! subp>agraph head+1 by    
ins]t+ be=e #bjag aft] ye>s2 &  7ii7 9 !
 matt] prec$+ clause 7i71 by ins]t+ &   
be=e #bjag aft] #bjje2 &  7,b7 by add+  
at ! end ! foll[+ new subp>agraph3  7,c7
 ,annual rulemak+ s*$ule = paym5t rates 
= #bjag & subsequ5t ye>s ,= #bjag & ea* 
subsequ5t ye>1 be=e ,april #a ( ! prec$+
 ye>1 ! ,secret>y %all1 by regulation & 

9 accordance ) ! notice & public comm5t 
p]iods requir$ "u p>agraph 7#b7 = su* a 
ye>1 annually det]m9e & ann\nce !       
foll[+3 7i7 ,! annual ,,ma capitation   
rate = ea* ,,ma paym5t area = su* ye>4  
7ii7 ,! risk & o!r factors to be us$ 9  
adju/+ su* rates "u subsection          
7a77#a77;,a7 = paym5ts = mon?s 9 su*    
ye>4  7iii7 ,) respect to ea* ,,ma      
region & ea* ,,ma regional plan = :i* a 
bid 0 submitt$ "u section #ahed1 ! ,,ma 
region-specific non-drug mon?ly b5*m>k  
am\nt = t region = ! ye> involv$4  7iv7 
,! major policy *anges to ! risk        
adju/m5t model1 & ! #e-/> rat+ sy/em    
e/abli%$ "u subsection 7o71 t are       
det]m9$ to h an economic impact4  2 &   
7#c7 9 p>agraph 7#b7--  7,a7 by ins]t+  
7or1 = #bjag & ea* subsequ5t ye>1 at    
lea/ #fj days7 aft] #de days2 &  7,b7 by
 ins]t+ 7= #bjag & ea* subsequ5t ye>1 ( 
no less ?an #cj days7 aft] opportunity4 
,pass$ ! ,h\se ( ,repres5tatives ,june  
#ag1 #bjae4;,cl]k4