117 STAT. 2220
PUBLIC LAW 108–173—DEC. 8, 2003
‘‘(ii) exceeds such CCA non-drug benchmark, the amount of the premium for the individual for the month shall be adjusted to ensure, that— ‘‘(I) the sum of the amount of the adjusted premium and the CCA non-drug benchmark for the area; is equal to ‘‘(II) the sum of the unadjusted premium plus the amount of such fee-for-service area-specific non-drug amount for the area. ‘‘(B) LIMITATION.—In no case shall the actual amount of an adjustment under subparagraph (A) for an area and month in a year result in an adjustment that exceeds the maximum adjustment permitted under subparagraph (C) for the area and year, or, if less, the maximum annual adjustment permitted under subparagraph (D) for the area and year. ‘‘(C) PHASE-IN OF ADJUSTMENT.—The amount of an adjustment under subparagraph (A) for a CCA area and year may not exceed the product of the phase-in fraction for the year under subsection (d)(3)(B) multiplied by the amount of the adjustment otherwise computed under subparagraph (A) for the area and year, determined without regard to this subparagraph and subparagraph (D). ‘‘(D) 5-PERCENT LIMITATION ON ADJUSTMENT.—The amount of the adjustment under this subsection for months in a year shall not exceed 5 percent of the amount of the monthly premium amount determined for months in the year under section 1839 without regard to subsections (b), (f), and (i) of such section and this subsection.’’. (b) CONFORMING AMENDMENTS.— (1) MA LOCAL PLANS.— (A) Section 1853(j)(1)(A) (42 U.S.C. 1395w–23(j)(1)(A)), as added by section 222(d), is amended by inserting ‘‘subject to section 1860C–1(d)(2)(A),’’ after ‘‘within an MA local area,’’. (B) Section 1853(b)(1)(B), as amended by section 222(f)(1), is amended by adding at the end the following new clause: ‘‘(iii) BENCHMARK ANNOUNCEMENT FOR CCA LOCAL AREAS.—The Secretary shall determine, and shall announce (in a manner intended to provide notice to interested parties), on a timely basis before the calendar year concerned, with respect to each CCA area (as defined in section 1860C–1(b)(1)(A)), the CCA nondrug monthly benchmark amount under section 1860C–1(e)(1) for that area for the year involved.’’. (2) PREMIUM ADJUSTMENT.— (A) Section 1839 (42 U.S.C. 1395r) is amended by adding at the end the following new subsection: ‘‘(h) POTENTIAL APPLICATION OF COMPARATIVE COST ADJUSTMENT IN CCA AREAS.— ‘‘(1) IN GENERAL.—Certain individuals who are residing in a CCA area under section 1860C–1 who are not enrolled in an MA plan under part C may be subject to a premium adjustment under subsection (f) of such section for months in which the CCA program under such section is in effect in such area.
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