,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #faji  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #ah1         
#bjbe,mr4 ,pocan 7= himself1 ,mr4       
,c>son1 ,mr4 ,coh51 ,ms4 ,de,lauro1 ,mr4
 ,doggett1 ,ms4 ,jayapal1 ,mr4 ,khanna1 
,ms4 ,norton1 ,ms4 ,ocasio-,cortez1 ,ms4
 ,s*ak[sky1 ,mr4 ,takano1 ,mr4 ,?an$>1  
,ms4 ,tlaib1 ,ms4 ,johnson ( ,texas1    
,ms4 ,mc,bride1 & ,ms4 ,om>7 introduc$ !
 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$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to e/abli% c]ta9 
requirem5ts ) respect to rates ( rev]s$ 
prior au?orization cov]age det]m9ations 
"u ,m$ic>e ,advantage plans4  #a4       
,e/abli%+ requirem5ts ) respect to rates
 ( rev]s$ prior au?orization cov]age    
det]m9ations "u ,m$ic>e ,advantage plans

 ,section #aheg ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #aciew-#bg7 is      
am5d$-- 7#a7 9 subsection 7e71 by add+  
at ! end ! foll[+ new p>agraph3  7#f7   
,requirem5t on rates ( rev]s$ prior     
au?orization cov]age det]m9ations  7,a7 
,9 g5]al ,9 ! case ( a ,m$ic>e          
,advantage plan t imposes any prior     
au?orization requirem5t ) respect to    
items or s]vices furni%$ dur+ a plan ye>
 beg9n+ on or aft] ! date t is #a ye>   
aft] ! date ( ! enactm5t ( ?is p>agraph1
 if ! ,secret>y det]m9es t su* plan     
exce$s ! all[able rate ( rev]s$ prior   
au?orization cov]age det]m9ations "u    
subp>agraph 7,b7 ) respect to su* plan  
ye>1 ! ,secret>y %all t]m9ate ! contract
 ) respect to ! (f]+ ( su* plan "u ?is  
section4  7,b7 ,all[able rate ( rev]s$  
prior au?orization cov]age det]m9ations 
,= purposes ( subp>agraph 7,a71 a       
,m$ic>e ,advantage plan exce$s !        
all[able rate ( rev]s$ prior            
au?orization cov]age det]m9ations "u ?is
 subp>agraph ) respect to a plan ye>    

if--  7i7 great] ?an #be p]c5t ( prior  
au?orization cov]age det]m9ations made  
dur+ su* plan ye> initially d5y cov]age 
& are lat]-- 7,i7 reconsid]$ & rev]s$   
pursuant to section #aheb7;g77#b72 or   
7,,ii7 appeal$ & rev]s$ pursuant to     
section #aheb7;g77#e72 or  7ii7 !       
,secret>y det]m9es t--  7,i7            
significantly few] prior au?orization   
cov]age det]m9ations made dur+ su* plan 
ye> t are reconsid]$ pursuant to section
 #aheb7;g77#b7 are rev]s$1 z comp>$ to !
 numb] ( su* det]m9ations made dur+ !   
previ\s plan ye> t are s reconsid]$ &   
rev]s$2 &  7,,ii7 ! r$uction 9 ! numb] (
 reconsid]$ & rev]s$ prior au?orization 
cov]age det]m9ations describ$ 9         
subclause 7,i7 occurr$ because ! ,m$ic>e
 ,advantage organization t (f]s su* plan
 fail$ to appropriately reconsid] prior 
au?orization cov]age det]m9ations made  
dur+ su* plan ye> pursuant to section   
#aheb7;g77#b74  7,c7 ,prior au?orization
 cov]age det]m9ation def9$ ,9 ?is       
p>agraph1 ! t]m prior au?orization      

cov]age det]m9ation means1 ) respect to 
a ,m$ic>e ,advantage plan1 a cov]age    
det]m9ation made "u section #aheb7;g7   
reg>d+ :e!r an individual enroll$ 9 su* 
plan is entitl$ to receive an item or   
s]vice "u ! prior au?orization          
requirem5t impos$ "u su* plan ) respect 
to su* item or s]vice4  2 &  7#b7 9     
subsection 7h77#a77;,a71 by ins]t+      
except 9 ! case ( a t]m9ation ( a       
contract due to failure to meet !       
requirem5t "u subsection 7e77#f71 be=e !
 ,secret>y4