1. Short title
This Act may be cited as the “Puerto Rico Integrity in Medicare Advantage Act”.
Puerto Rico Integrity in Medicare Advantage Act
A BILL
To amend title XVIII of the Social Security Act to provide for temporary stabilization of Medicare Advantage payments following Hurricane Maria.
2. Temporary stabilization of Medicare Advantage payments following Hurricane Maria
in paragraph (1)(B), by striking “subsequent year” and inserting “subsequent year, subject to paragraph (6),”; and
by adding at the end the following new paragraph:
“(6) Average geographic adjustment floor—For each of 2020, 2021, and 2022, when calculating the adjusted average per capita cost under section 1876(a)(4) for the purposes of establishing the base payment amount specified in paragraph (2)(E), the average geographic adjustment shall not be less than 0.70 for any area. For purposes of the previous sentence, the Secretary may define the term average geographic adjustment by program instruction or otherwise.”
Ensuring payments flow to Puerto Rico providers and patients— Section 1854(a)(6) of the Social Security Act (42 U.S.C. 1395w–24(a)(6)) is amended by adding at the end the following new subparagraph:
“(C) Strengthening support to health care providers in Puerto Rico—With respect to plans serving areas in Puerto Rico, of the increase in blended benchmark amount attributable to section 1853(n)(6), no less than 50 percent is directed toward provider compensation.”