United States. Congress

“ Identification of high quality plans in top quintile based on projected enrollment.—The Secretary shall, based on the scores for each plan under clause (i) (I) and the Secretary’s projected enrollment for each plan and subject to clause (iv) , identify those Medicare Advantage plans with the highest score that, based upon projected enrollment, are projected to include in the aggregate 20 percent of the total projected enrollment for the year. For purposes of this subsection, a plan so identified shall be referred to in this subsection as a ‘high quality MA plan’. ”

“ Notification.—The Secretary, in the annual announcement required under subsection (b) (1) (B) in 2011 and each succeeding year, shall notify the Medicare Advantage organization that is offering a high quality plan or an improved quality plan of such identification for the year and the quality performance payment adjustment for such plan for the year. ”

“ Improving Risk Adjustment for Payments. (a) Report to Congress.— Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that evaluates the adequacy of the risk adjustment system under section 1853 (a) (1) (C) of the Social Security Act (42 U.S.C. 1395–23 (a) (1) (C) ) in predicting costs for beneficiaries with chronic or co-morbid conditions, beneficiaries dually-eligible for Medicare and Medicaid, and non-Medicaid eligible low-income beneficiaries ”