,,ib ,union ,cal5d> ,no4 #aaf #aad? ,,congress #a/ ,session ,h4 ,r4 #begi ,report ,no4 #aad-afj1 ,"p ,i ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,may #bi1 #bjae ,mrs4 ,black 7= h]self1 ,mr4 ,blum5au]1 ,mr4 ,gu?rie1 & ,mr4 ,loebsack7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,ways & ,means1 & 9 addition to ! ,committee on ,en]gy & ,comm]ce1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,june #af1 #bjae ,additional sponsor3 ,ms4 ,s9ema ,june #af1 #bjae ,report$ f ! ,committee on ,ways & ,means ) an am5dm5t ,/rike out all aft] ! enact+ clause & ins]t ! "p pr9t$ 9 italic ,june #af1 #bjae ,! ,committee on ,en]gy & ,comm]ce dis*>g$2 committ$ to ! ,committee ( ! ,:ole ,h\se on ! ,/ate ( ! ,union & ord]$ to be pr9t$ ,= text ( introduc$ bill1 see copy ( bill z introduc$ on ,may #bi1 #bjae ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to improve ! risk adju/m5t "u ! ,m$ic>e ,advantage program1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,secur+ ,c>e = ,s5iors ,act ( #bjae4 #b4 ,improvem5ts to ,,ma risk adju/m5t sy/em ,section #ahec7;a77#a77;,c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bc7;a77#a77;,c77 is am5d$ by add+ at ! end ! foll[+ new clauses3 7iv7 ,evaluation & subsequ5t revision ( ! risk adju/m5t sy/em to acc\nt = *ronic conditions & o!r factors = ! purpose ( mak+ ! risk adju/m5t sy/em m accurate1 transp>5t1 & regul>ly updat$ 7,i7 ,revision bas$ on numb] ( *ronic conditions ,! ,secret>y %all revise = #bjag & p]iodically !reaft]1 ! risk adju/m5t sy/em "u ?is subp>agraph s t a risk score "u su* sy/em1 ) respect to an individual1 takes into acc\nt ! numb] ( *ronic conditions ) :i* ! individual has be5 diagnos$4 7,,ii7 ,evaluation ( diff]5t risk adju/m5t models ,! ,secret>y %all evaluate ! impact ( includ+ two ye>s ( data to comp>e ! models us$ to det]m9e risk scores = #bjac & #bjad "u su* sy/em4 7,,iii7 ,evaluation & analysis on *ronic kidney disease 7,,ckd7 codes ,! ,secret>y %all evaluate ! impact ( remov+ ! diagnosis codes relat$ to *ronic kidney disease 9 ! #bjad risk adju/m5t model & conduct an analysis ( be/ practices ( ,,ma plans to sl[ disease progression relat$ to *ronic kidney disease4 7,,iv7 ,evaluation & recomm5dations on use ( enc\nt] data ,! ,secret>y %all evaluate ! impact ( includ+ #aj p]c5t ( enc\nt] data 9 comput+ paym5t = #bjaf & ! read9ess ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices to incorporate enc\nt] data 9 risk scores4 ,9 conduct+ su* evaluation1 ! ,secret>y %all use data collect$ z enc\nt] data on or aft] ,janu>y #a1 #bjab1 %all analyze su* data = accuracy & complet5ess & issue recomm5dations = improv+ su* accuracy & complet5ess1 & %all n increase ! p]c5tage ( su* enc\nt] data us$ unless ! ,secret>y releases ! data publicly1 indicates h[ su* data w be weight$ 9 comput+ ! risk scores1 & ensures t ! data reflects ! degree & co/ ( c>e coord9ation "u ,,ma plans4 7,v7 ,conduct ( evaluations ,evaluations & analyses "u subclause 7,,ii7 ?r\gh 7,,iv7 %all include an actu>ial op9ion f ! ,*ief ,actu>y ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices ab\t ! reasonabl5ess ( ! me?ods1 assumptions1 & conclusions ( su* evaluations & analyses4 ,! ,secret>y %all consult ) ! ,m$ic>e ,paym5t ,advisory ,commission & accept & consid] comm5ts ( /akehold]s1 su* z manag$ c>e organizations & b5efici>y gr\ps1 on su* evaluation & analyses4 ,! ,secret>y %all complete su* evaluations & analyses 9 a mann] t p]mits ! results to be appli$ = plan ye>s beg9n+ ) ! second plan ye> t beg9s aft] ! date ( ! enactm5t ( ?is clause4 7,,vi7 ,implem5tation ( revisions bas$ on evaluations ,if ! ,secret>y det]m9es1 bas$ on su* an evaluation or analysis1 t revisions to ! risk adju/m5t sy/em to address ! matt]s describ$ 9 any ( subclauses 7,,ii7 ?r\gh 7,,iv7 w\ld make ! risk adju/m5t sy/em "u ?is subp>agraph bett] reflect & appropriately weight = ! population t is s]v$ by ! plan1 ! ,secret>y %all1 beg9n+ ) #bjag1 & p]iodically !reaft]1 make su* revisions4 7,,vii7 ,p]iodic report+ to ,congress ,) respect to plan ye>s beg9n+ ) #bjag & e ?ird ye> !reaft]1 ! ,secret>y %all submit to ,congress a report on ! mo/ rec5t revisions 7if any7 made "u ?is clause1 includ+ ! evaluations conduct$ "u subclauses 7,,ii7 ?r\gh 7,,iv74 7v7 ,no *anges to adju/m5t factors t prev5t activities consi/5t ) national heal? policy goals ,9 mak+ any *anges to ! adju/m5t factors1 includ+ adju/m5t = heal? /atus "u p>agraph 7#c71 ! ,secret>y %all ensure t ! *anges d n prev5t ,m$ic>e ,advantage organizations f p]=m+ or und]tak+ activities t are consi/5t ) national heal? policy goals1 includ+ activities to promote e>ly detection & bett] c>e coord9ation1 ! use ( heal? risk assessm5ts1 c>e plans1 & programs to sl[ ! progression ( *ronic diseases4 7vi7 ,opportunity = review & public comm5t reg>d+ *anges to adju/m5t factors ,= *anges to adju/m5t factors effective = #bjag & subsequ5t ye>s1 9 addition to provid+ notice ( su* *anges 9 ! ann\ncem5t "u subsection 7b77#b71 ! ,secret>y %all provide an opportunity = review ( propos$ *anges ( n less ?an #fj days & a public comm5t p]iod ( n less ?an #cj days be=e implem5t+ su* *anges4 4 #c4 ,s5se ( ,congress ,x is ! s5se ( ,congress t-- 7#a7 ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices has inadv]t5tly creat$ a /> rat+ sy/em "u section #ahec7o77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bc7o77#d77 = ,m$ic>e ,advantage plans t lacks prop] acc\nt+ = ! socioeconomic /atus ( enrollees 9 su* plans & ! ext5t to :i* su* plans s]ve individuals :o are also eligible = m$ical assi/ance "u title ,,xix ( su* ,act2 & 7#b7 ,congress w "w ) ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices & /akehold]s1 includ+ b5efici>y gr\ps & manag$ c>e organizations1 to ensure t su* rat+ sy/em prop]ly acc\nts = ! socioeconomic /atus ( enrollees 9 su* plans & ! ext5t to :i* su* plans s]ve su* individuals describ$ 9 p>agraph 7#a74 ,june #af1 #bjae ,report$ f ! ,committee on ,ways & ,means ) an am5dm5t ,june #af1 #bjae ,! ,committee on ,en]gy & ,comm]ce dis*>g$2 committ$ to ! ,committee ( ! ,:ole ,h\se on ! ,/ate ( ! ,union & ord]$ to be pr9t$