,,ii  #aahth ,,congress  #ast ,session  
,s4 #ajjb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #bh1    
#bjbc ,mr4 ,cassidy 7for himself and    
,mr4 ,merkley7 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 improve risk         
adjustment under ,medicare ,advantage4  
#a4 ,short title ,this ,act may be cited
 as the ,no ,unreasonable ,payments1    
,coding1 ,or ,diagnoses for the ,elderly
 ,act or the ,no ,,upcode ,act4  #b4    
,improving risk adjustment under        
,medicare ,advantage  7a7 ,use of #b    
years of diagnostic data ,section       
#ahec7;a77#c77;,c77iii7 of the ,social  
,security ,act 7#db ,u4,s4,c4           
#aciew-#bc7;a77#c77;,c77iii77 is        
amended--  7#a7 by striking             
methodology4--,such risk and inserting  
8methodology4--  7,i7 ,in general       
,subject to subclause 7,,ii71 such risk 
2 and  7#b7 by adding at the end the    

following new subclauses3  7,,ii7 ,use  
of health status data ,for #bjbd and    
each subsequent year1 the ,secretary    
shall use #b years of diagnostic data   
7when available7 under such risk        
adjustment methodology4  4  7b7         
,exclusion of diagnoses collected from  
chart reviews and health risk           
assessments  7#a7 ,in general ,section  
#ahec7;a77#a77;,c7 of such ,act 7#db    
,u4,s4,c4 #aciew-#bc7;a77#a77;,c77 is   
amended by adding at the end the        
following new clause3  7iv7 ,exclusion  
of diagnoses collected from chart       
reviews and health risk assessments     
7,i7 ,in general ,for #bjbd and each    
subsequent year1 for purposes of        
establishing the payment adjustment     
factors and adjusting payment based on  
health status under clause 7i71 the     
,secretary shall not take into account a
 diagnosis collected from a chart review
 or a health risk assessment4  7,,ii7   
,identification of diagnoses collected  
from chart reviews and health risk      

assessments ,the ,secretary shall       
establish procedures to provide for the 
identification and verification of      
diagnoses collected from chart reviews  
and health risk assessments4  4  7c7    
,application of coding adjustment       
,section #ahec7;a77#a77;,c77ii7 of such 
,act 7#db ,u4,s4,c4                     
#aciew-#bc7;a77#a77;,c77ii77 is         
amended--  7#a7 in subclause 7,,iii71 by
 striking ,in calculating and inserting 
,subject to subclause 7,v71 in          
calculating2 and  7#b7 by adding at the 
end the following new subclause3  7,v7  
,in calculating such adjustment for     
#bjbd and each subsequent year1 the     
,secretary shall evaluate the impact on 
risk scores for ,medicare ,advantage    
enrollees of differences in coding      
patterns between ,medicare ,advantage   
plans and providers under parts ,a and  
,b and publicly report the results of   
such evaluation4 ,the ,secretary shall  
ensure that such adjustment1 which may  
include adjustment on a plan or contract

 level1 fully accounts for the impact of
 coding pattern differences not         
otherwise accounted for to the extent   
that the ,secretary identifies such     
differences through annual evaluation4  
4