,,ii #aadth ,,congress #ast ,session ,s4 #bajd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #cj1 #bjae ,mr4 ,portman 7for himself and ,mr4 ,casey7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to provide relief to ,medicare ,advantage plans with a significant number of dually eligible or low-income subsidy beneficiaries and to prevent the termination of two star plans4 #a4 ,short title ,this ,act may be cited as the ,preserving ,medicare ,advantage for all ,medicare ,beneficiaries ,act of #bjae4 #b4 ,findings ,congress makes the following findings3 7#a7 ,in the ,,impact ,act of #bjad 7,public ,law #aac-ahe71 ,congress recognized the potential effects of socioeconomic status and dual eligible populations on the ,medicare ,advantage ,,stars rating system by requesting the ,assistant ,secretary of ,planning and ,evaluation in the ,department of ,health and ,human ,services undertake studies on this population and the ,medicare program4 7#b7 ,studies published in the past year have shown the need for an interim policy until the comprehensive results of the studies undertaken as part of the ,,impact ,act of #bjad are published4 ,an adjustment for #bjaf is necessary while ,congress continues to work to achieve an appropriate policy for a temporary bridge until the results from the studies undertaken by the ,assistant ,secretary of ,planning and ,evaluation in the ,department of ,health and ,human ,services under such ,act are finalized4 #c4 ,delay in authority to terminate contracts for certain medicare advantage plans failing to achieve minimum quality ratings ,section #aheg7;h7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bg7;h77 is amended by adding at the end the following new paragraph3 7#c7 ,delay in contract termination authority for certain plans failing to achieve minimum quality rating 7,a7 ,in general ,subject to subparagraph 7,b71 the ,secretary may not terminate a contract under this section with respect to the offering of an ,,ma plan by a ,medicare ,advantage organization solely because the ,,ma plan has failed to achieve a minimum quality rating under the #e-star rating system established under section #ahec7o7 during the period beginning on the date of the enactment of this paragraph and through the end of plan year #bjah4 7,b7 ,application only to plans receiving a quality rating of at least #b stars ,subparagraph 7,a7 shall only apply with respect to a contract with respect to the offering of an ,,ma plan that has a quality rating under section #ahec7o77#d7 of at least #b stars for the most recent plan year4 4 #d4 ,demonstration project to direct quality improvement programs to address socioeconomic status disparities in ,medicare ,advantage plans 7a7 ,establishment 7#a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall establish a demonstration project under this section to provide funds to ,,ma organizations offering one or more qualified ,,ma plans for use in developing or expanding programs or services with respect to such plans that seek to improve health care delivery and outcomes of care for enrollees with low socioeconomic status4 7#b7 ,duration ,the demonstration project under this section shall be conducted for a period of #a year beginning in plan year #bjaf4 7b7 ,definitions ,in this section3 7#a7 ,,ma organization2 ,,ma plan ,the terms ,,ma organization and ,,ma plan have the meaning given such terms in subsections 7a77#a7 and 7b77#a71 respectively1 of section #ahei of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bh74 7#b7 ,qualified ,,ma plan 7,a7 ,the term qualified ,,ma plan means an ,,ma plan described in subparagraph 7,b7 or 7,c74 7,b7 ,an ,,ma plan is described in this subparagraph if the ,,ma plan meets each of the following criteria3 7i7 ,the plan has a quality rating under section #ahec7o77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bc7o77#d77 of at least #c4be stars but not more than #d stars for the most recent plan year4 7ii7 ,not less than #de percent of enrollees in the plan are one or both of the following3 7,i7 ,eligible for a low income subsidy under section #ahfj;,d-#ad of such ,act 7#db ,u4,s4,c4 #aciew-#aad74 7,,ii7 ,dually eligible for benefits under the ,medicare program under title ,,xviii of such ,act 7#db ,u4,s4,c4 #acie et seq47 and the ,medicaid program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq474 7,c7 ,an ,,ma plan is described in this subparagraph if the ,,ma plan meets each of the following criteria3 7i7 ,the plan has a quality rating under section #ahec7o77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bc7o77#d77 of at least #c4j stars but not more than #d stars for the most recent plan year4 7ii7 ,not less than #fj percent of enrollees in the plan are one or both of the following3 7,i7 ,eligible for a low income subsidy under section #ahfj;,d-#ad of such ,act 7#db ,u4,s4,c4 #aciew-#aad74 7,,ii7 ,dually eligible for benefits under the ,medicare program under title ,,xviii of such ,act 7#db ,u4,s4,c4 #acie et seq47 and the ,medicaid program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq474 7c7 ,use of funds 7#a7 ,in general ,subject to paragraph 7#b71 funds received under the demonstration project by an ,,ma organization with respect to a qualified ,,ma plan shall be used under the ,quality ,improvement ,program of the organization under section #aheb7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;e77 to target improvement by the qualified ,,ma plan with respect to two or more triple-weighted measures under the #e-star rating system under section #ahec7o77#d7 of such ,act 7#db ,u4,s4,c4 #aciew-#bc7o77#d774 7#b7 ,focus on outcome measure 7,a7 ,in general ,except as provided in subparagraph 7,b71 at least one of the measures targeted under paragraph 7#a7 shall be an outcome measure4 7,b7 ,exception ,an ,,ma organization may apply to the ,secretary for an exception to subparagraph 7,a7 in order to focus on only process measures under this subsection4 7d7 ,inclusion in annual quality improvement program report ,an ,,ma organization receiving funds under the demonstration project shall include1 as part of the annual report to the ,secretary on the ,quality ,improvement ,program of the organization under such section #aheb7;e7 for each year of the demonstration project1 with respect to each qualified ,,ma plan offered by the organization1 the results of the targeting of plan improvement on measures under subsection 7c7 during the preceding year4 7e7 ,funding 7#a7 ,in general ,for purposes of carrying out the demonstration project under this section1 subject to paragraph 7#b71 the ,secretary shall provide for the transfer from the ,federal ,hospital ,insurance ,trust ,fund under section #ahag of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7 and the ,federal ,supplementary ,medical ,insurance ,trust ,fund under section #ahda of such ,act 7#db ,u4,s4,c4 #aciet71 in such proportion as the ,secretary determines appropriate1 of an amount equal to the amount the ,secretary determines is equal to the estimated total savings to the ,medicare program as a result of the implementation of the amendment made by section #b to the ,centers for ,medicare ,medicaid ,services ,program ,management ,account4 7#b7 ,administration ,the ,secretary may retain up to #aj percent of the funds transferred under paragraph 7#a7 to administer the demonstration project under this section and the remainder of such funds shall be distributed in accordance with this section to ,,ma organizations offering qualified ,,ma plans based on the enrollment in such plans of individuals described in each of subclauses 7,i7 and 7,,ii7 of subsections 7b77#b77;,b77ii7 and 7b77#b77;,c77ii74 7#c7 ,availability ,amounts transferred under paragraph 7#a7 shall remain available until expended4