,,ii  #aai? ,,congress  #b;d ,session   
,s4 #chdh  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,febru>y #aa1 #bjbf    
,mr4 ,scott ( ,s\? ,c>ol9a introduc$ !  
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to require ! ,secret>y ( 
,heal? & ,human ,s]vices to publi%      
in=mation on exp5ditures "u ! ,m$ic>e   
program1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,apples 
to ,apples ,comp>ison ,act ( #bjbf4  #b4
 ,requir+ ! ,secret>y ( ,heal? & ,human 
,s]vices to publi% in=mation on         
exp5ditures "u ! ,m$ic>e program        
,section #ahgd ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciekk7 is am5d$-- 
7#a7 9 subsection 7g7-- 7,a7 9 p>agraph 
7#a7--  7i7 9 ! matt] prec$+ subp>agraph
 7,a71 by ins]t+ 7&1 beg9n+ ) #bjbg1    
publi% on ! public website ( ! ,c5t]s = 
,m$ic>e  ,m$icaid ,s]vices 9            
ma*9e-readable files in=mation on7 aft] 
a report on2  7ii7 9 subp>agraph 7,a71  

by ins]t+ 7&1 beg9n+ ) #bjbg1 by c\nty &
 ,metropolitan ,/ati/ical ,area7 aft]   
,/ate2 &  7iii7 9 subp>agraph 7,b7--    
7,i7 9 clause 7ii71 by /rik+ & at ! end2
  7,,ii7 9 clause 7iii71 by /rik+ !     
p]iod & ins]t+ 2 &2 &  7,,iii7 by add+  
at ! end ! foll[+ new clause3  7iv7     
beg9n+ ) #bjbg1 ea* category (          
individuals describ$ 9 subsection       
7h77#a74  2 &  7,b7 by add+ at ! end !  
foll[+ new p>agraph3  7#c7 ,special rule
 = #bjbg report & publication (         
in=mation ,z "p ( ! report & publication
 ( in=mation requir$ "u p>agraph 7#a7 = 
#bjbg1 ! ,secret>y %all include         
enrollm5t in=mation submitt$ "u ?is     
subsection = ea* prec$+ ye> 7beg9n+ )   
#bjae71 brok5 d[n by c\nty &            
,metropolitan ,/ati/ical ,area & provid$
 = ea* category ( individuals describ$ 9
 subsection 7h77#a74  2 &  7#b7 by add+ 
at ! end ! foll[+ new subsection3  7h7  
,in=mation on exp5ditures  7#a7 ,9 g5]al
 ,n lat] ?an #cj days aft] ! la/ day (  
ea* ye> 7beg9n+ ) #bjbg71 ! ,secret>y   

%all1 = ea* c\nty & ea* ,metropolitan   
,/ati/ical ,area1 publi% on ! public    
website ( ! ,c5t]s = ,m$ic>e  ,m$icaid  
,s]vices 9 ma*9e-readable files ! total 
& av]age exp5ditures "u ?is title =     
items & s]vices furni%$ to individuals  
entitl$ to b5efits "u "p ,a or enroll$  
"u "p ,b resid+ 9 su* c\nty or          
,metropolitan ,/ati/ical ,area = ea*    
mon? occurr+ 9 ! specifi$ hi/orical     
p]iod & = ea* mon? occurr+ 9 ! specifi$ 
project$ p]iod ) respect to su* ye>1    
brok5 d[n by ! foll[+ categories (      
individuals3  7,a7 ,individuals entitl$ 
to b5efits "u "p ,a & n enroll$ "u "p   
,b4  7,b7 ,individuals :o are--  7i7 n  
entitl$ to b5efits "u "p ,a2  7ii7      
enroll$ "u "p ,b2 &  7iii7 n enroll$ "u 
a ,m$ic>e ,advantage plan "u "p ,c4     
7,c7 ,individuals :o are--  7i7 entitl$ 
to b5efits "u "p ,a & enroll$ "u "p ,b2 
&  7ii7 n enroll$ "u a ,m$ic>e          
,advantage plan "u "p ,c4  7,d7         
,individuals describ$ 9 subp>agraph 7,a7
 :o are enroll$ 9 a prescription drug   

plan "u "p ,d4  7,e7 ,individuals       
describ$ 9 subp>agraph 7,b7 :o are      
enroll$ 9 a prescription drug plan "u "p
 ,d4  7,f7 ,individuals describ$ 9      
subp>agraph 7,c7 :o are enroll$ 9 a     
prescription drug plan "u "p ,d4  7,g7  
,individuals describ$ 9 subp>agraph 7,a7
 :o are n enroll$ 9 a prescription drug 
plan "u "p ,d4  7,h7 ,individuals       
describ$ 9 subp>agraph 7,b7 :o are n    
enroll$ 9 a prescription drug plan "u "p
 ,d4  7,i7 ,individuals describ$ 9      
subp>agraph 7,c7 :o are n enroll$ 9 a   
prescription drug plan "u "p ,d4  7,j7  
,individuals describ$ 9 subp>agraph 7,a7
 :o are enroll$ 9 a ,f$]al heal? c>e    
program 7z def9$ 9 section #aabh;,b7 or 
a heal? plan "u *apt] #hi ( title #e1   
,unit$ ,/ates ,code4  7,k7 ,individuals 
describ$ 9 subp>agraph 7,b7 :o are      
enroll$ 9 su* a program or plan4  7,l7  
,individuals describ$ 9 subp>agraph 7,c7
 :o are enroll$ 9 su* a program or plan4
  7,m7 ,individuals describ$ 9          
subp>agraph 7,a7 :o are n enroll$ 9 su* 

a program or plan4  7,n7 ,individuals   
describ$ 9 subp>agraph 7,b7 :o are n    
enroll$ 9 su* a program or plan4  7,o7  
,individuals describ$ 9 subp>agraph 7,c7
 :o are n enroll$ 9 su* a program or    
plan4  7,p7 ,individuals describ$ 9     
subp>agraph 7,a7 :o are enroll$ 9 a gr\p
 heal? plan 7z def9$ 9 section #bgia ( !
 ,public ,heal? ,s]vice ,act7 or a      
m$ic>e supplem5tal policy "u section    
#ahhb4  7,q7 ,individuals describ$ 9    
subp>agraph 7,b7 :o are enroll$ 9 su* a 
plan or policy4  7,r7 ,individuals      
describ$ 9 subp>agraph 7,c7 :o are      
enroll$ 9 su* a plan or policy4  7,s7   
,individuals describ$ 9 subp>agraph 7,a7
 :o are n enroll$ 9 su* a plan or       
policy4  7,t7 ,individuals describ$ 9   
subp>agraph 7,b7 :o are n enroll$ 9 su* 
a plan or policy4  7,u7 ,individuals    
describ$ 9 subp>agraph 7,c7 :o are n    
enroll$ 9 su* a plan or policy4  7,v7   
,individuals enroll$ 9 a specializ$ ,,ma
 plan = special ne$s individuals1 brok5 
d[n by ea* type ( plan4  7,w7           

,individuals enroll$ 9 an ,,ma plan o!r 
?an a plan describ$ 9 subp>agraph 7,v74 
7,x7 ,individuals enroll$ 9 an ,,ma     
plan4  7,y7 ,individuals describ$ 9     
subp>agraph 7,x7 :o are enroll$ 9 a     
,f$]al heal? c>e program 7z def9$ 9     
section #aabh;,b7 or a heal? plan "u    
*apt] #hi ( title #e1 ,unit$ ,/ates     
,code4  7,z7 ,individuals describ$ 9    
subp>agraph 7,x7 :o are n enroll$ 9 su* 
a program or plan4  7,,aa7 ,individuals 
describ$ 9 subp>agraph 7,x7 :o are      
enroll$ 9 a gr\p heal? plan 7z def9$ 9  
section #bgia ( ! ,public ,heal? ,s]vice
 ,act7 or a m$ic>e supplem5tal policy "u
 section #ahhb4  7,,bb7 ,individuals    
describ$ 9 subp>agraph 7,x7 :o are n    
enroll$ 9 su* a plan or policy4  7,,cc7 
,individuals describ$ 9 subp>agraph 7,x7
 :o are enroll$ 9 a prescription drug   
plan "u "p ,d4  7,,dd7 ,individuals     
describ$ 9 subp>agraph 7,x7 :o are n    
enroll$ 9 su* a plan4  7,,ee7           
,individuals describ$ 9 subp>agraph 7,x7
 :o are enroll$ 9 an ,,ma-,,pd plan4    

7,,ff7 ,individuals describ$ 9          
subp>agraph 7,x7 :o are n enroll$ 9 su* 
a plan4  7,,gg7 ,individuals describ$ 9 
subp>agraph 7,,cc7 or 7,,ee7 :o are     
enroll$ 9 a ,f$]al heal? c>e program 7z 
def9$ 9 section #aabh;,b7 or a heal?    
plan "u *apt] #hi ( title #e1 ,unit$    
,/ates ,code4  7,,hh7 ,individuals      
describ$ 9 subp>agraph 7,,cc7 or 7,,ee7 
:o are n enroll$ 9 su* a program or     
plan4  7,,ii7 ,individuals enroll$ 9 an 
employ] gr\p waiv] plan4  7#b7          
,def9itions ,= purposes ( ?is           
subsection3 7,a7 ,specifi$ hi/orical    
p]iod ,! t]m specifi$ hi/orical p]iod   
means1 ) respect to a ye>1 ! #aj-ye>    
p]iod end+ on ! la/ day ( su* ye>4  7,b7
 ,specifi$ project$ p]iod ,! t]m        
specifi$ project$ p]iod means1 ) respect
 to a ye>1 ! p]iod beg9n+ on ! fir/ day 
( ! subsequ5t ye> ( a duration specifi$ 
by ! ,secret>y 7b 9 no case to exce$ a  
duration ( #e ye>s74  4  #c4 ,med,p,a,c 
analysis ( ,m$ic>e ,advantage &         
fee-=-s]vice exp5ditures ,section       

#ahje7;b7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;b-#f7;b77 is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 
7#ab7 ,analysis ( ,m$ic>e ,advantage &  
fee-=-s]vice exp5ditures  7,a7 ,9 g5]al 
,! ,commission %all1 z "p ( ! report    
describ$ 9 p>agraph 7#a77;,c7 submitt$ =
 ea* ye> 7beg9n+ ) #bjbg71 include a    
retrospective analysis ( av]age         
exp5ditures "u ?is title = individuals  
enroll$ 9 a ,m$ic>e ,advantage plan "u  
"p ,c comp>$ to av]age exp5ditures "u   
?is title = individuals entitl$ to      
b5efits "u "p ,a & enroll$ "u "p ,b :o  
are eligible to enroll "u su* a plan b  
:o are n s enroll$4  7,b7 ,consid]ations
 ,9 prep>+ ea* analysis describ$ 9      
subp>agraph 7,a71 ! ,commission %all--  
7i7 use data provid$ by ! ,*ief ,actu>y 
( ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices 
& ! ,bo>ds ( ,tru/ees ( ! ,f$]al        
,hospital ,insurance ,tru/ ,fund        
e/abli%$ "u section #ahag & ! ,f$]al    
,supplem5t>y ,m$ical ,insurance ,tru/   
fund e/abli%$ "u section #ahda & su* o!r

 data z ! ,commission det]m9es          
appropriate2  7ii7 take into acc\nt--   
7,i7 diff]5ces 9 value provid$ "u       
,m$ic>e ,advantage plans comp>$ to !    
value provid$ "u p>ts ,a & ,b1 su* z !  
exi/5ce ( out-(-pocket exp5diture caps1 
supplem5tal b5efits available "u su*    
plans1 & ! integration ( b5efits = cov]$
 "p ,d drugs "u c]ta9 su* plans2  7,,ii7
 demographic diff]5ces ( individuals    
enroll$ 9 ,m$ic>e ,advantage plans      
comp>$ to individuals entitl$ to b5efits
 "u "p ,a & enroll$ "u "p ,b :o are n   
enroll$ 9 su* a plan2 &  7,,iii7        
diff]5ces 9 ,,hcc risk scores2 &  7iii7 
n take into acc\nt any favorable        
selection diff]5ces ) respect to        
enrollm5t 9 su* plans4  7,c7            
,publication requirem5ts ,) respect to  
ea* analysis describ$ 9 subp>agraph     
7,a71 ! ,commission %all-- 7i7 make     
public all data us$ 9 prep>+ su*        
analysis 9 a mann] t--  7,i7 all[s      
replication ( su* analysis2 &  7,,ii7   
protects ! confid5tiality ( p]sonal     

in=mation ( individuals entitl$ to      
b5efits "u "p ,a & enroll$ "u "p ,b2    
7ii7 n lat] ?an #fj days prior to !     
submission ( su* analysis1 make public !
 me?odology us$ to conduct su* analysis 
& all[ at lea/ #cj days = public comm5t 
on su* me?odology2 &  7iii7 make public 
a response to ea* su* comm5t receiv$ on 
! me?odology prior to or concurr5t ) !  
submission ( su* analysis4  4  #d4      
,tru/ees report ( exp5diture in=mation  
,section #ahgd ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciekk71 z am5d$ by
 section #b1 is am5d$ by add+ at ! end !
 foll[+ new subsection3  7i7 ,tru/ees'  
report ( exp5diture in=mation  7#a7 ,9  
g5]al ,! ,bo>ds ( ,tru/ees ( ! ,f$]al   
,hospital ,insurance ,tru/ ,fund        
e/abli%$ "u section #ahag & ! ,f$]al    
,supplem5t>y ,m$ical ,insurance ,tru/   
,fund e/abli%$ "u section #ahda %all    
jo9tly1 z "p ( ! reports describ$ 9     
sections #ahag7;b77#b7 & #ahda7;b77#b7  
submitt$ = a ye> 7beg9n+ ) #bjbg71      
include in=mation on aggregate & av]age 

exp5ditures "u ?is title = ! foll[+     
categories ( individuals &1 9 ! case ( !
 category describ$ 9 subp>agraph 7,c71  
brok5 d[n by exp5ditures "u "p ,a &     
exp5ditures "u "p ,b3  7,a7 ,individuals
 entitl$ to b5efits "u "p ,a & n enroll$
 "u "p ,b4  7,b7 ,individuals enroll$ "u
 "p ,b & n entitl$ to b5efits "u "p ,a4 
7,c7 ,individuals entitl$ to b5efits "u 
"p ,a1 enroll$ "u "p ,b1 & n enroll$ 9 a
 ,m$ic>e ,advantage plan "u "p ,c4  7#b7
 ,provision ( disaggregat$ in=mation ,! 
,bo>ds ( ,tru/ees describ$ 9 p>agraph   
7#a7 %all1 z "p ( all exp5diture data   
7includ+ data tables7 made public by su*
 ,bo>ds1 disaggregate su* data1 to !    
ext5t practicable1 bas$ on ! categories 
( individuals describ$ 9 p>agraph 7#a74 
4