12 2 STA T . 2 57 1 PUBLIC LA W 11 0– 275 —J UL Y 15 , 200 8strik i ng‘ ‘ a s uf fi c i e nt nu mb er ’ ’t h r o ugh ‘‘terms of the pl an’’ an d inserting ‘‘a sufficient number and range of pro v iders w ithin such categor y to meet the access standards in sub - paragraphs (A) through ( E ) of paragraph ( 1 )’’ . ( B )E F F ECTIV E DA TE. —T he amendment made by subparagraph (A) shall apply to plan year 20 10 and subse- q uent plan years. (b) CL A R IFICATI ONR E G ARDING U TILI Z ATION.— S ection 1 859 (b)(2) of the Social Security Act ( 4 2 U.S.C. 1 3 95w – 28(b)(2)) is amended by adding at the end the following flush sentence
‘‘ N othing in subparagraph (B) shall be construed to preclude a plan from varying rates for such a provider based on the specialty of the provider , the location of the provider, or other factors related to such provider that are not related to utili z a- tion, or to preclude a plan from increasing rates for such a provider based on increased utilization of specified preventive or screening services.’’. SEC.163 . R E VI SI ON S T O QUAL IT Y I MP ROVEMENT PRO G RAMS. (a) RE QU IRE M ENT FOR M A P RIVATE F EE-FOR-SERVICE AND MSA PLAN S TO H AVE A Q UALIT YI M P ROVEMENT PROGRAM.—Section 1852(e)(1) of the Social Security Act (42 U.S.C. 1395w–22(e)(1)) is amended by striking ‘‘(other than an MA private fee-for-service plan or an MSA plan)’’. (b) D ATA COLLECTION REQUIREMENTS FOR MA REGIONAL PLANS, MA PRIVATE FEE-FOR-SERVICE PLANS, AND MSA PLANS.—Section 1852(e)(3)(A) of the Social Security Act (42 U.S.C. 1395w– 22(e)(3)(A)) is amended— (1) in clause (i), by adding at the end the following new sentence: ‘‘ W ith respect to MA private fee-for-service plans and MSA plans, the requirements under the preceding sentence may not e x ceed the requirements under this subparagraph with respect to MA local plans that are preferred provider organization plans, except that, for plan year 2010, the limita- tion under clause (iii) shall not apply and such requirements shall apply only with respect to administrative claims data.’’ (2) by striking clause (ii)
and (3) in clause (iii)— (A) in the heading— (i) by inserting ‘‘LOCAL’’ after ‘‘TO’’; and (ii) by inserting ‘‘AND MA REGIONAL PLANS’’ after ‘‘ORGANIZATIONS’’; and (B) by inserting ‘‘and to MA regional plans’’ after ‘‘organization plans’’. (c) EFFECTIVE DATE.—The amendments made by this section shall apply to plan years beginning on or after J anuary 1, 2010. SEC. 16 4 . REVISIONS RELATING TO SPECIALI Z E D MEDICARE ADVAN - TAGE PLANS F OR SPECIAL NEEDS INDIVIDUALS. (a) E X TENSION OF AUT H ORITY TO RESTRICT ENROLLMENT.—Sec- tion 1859(f) of the Social Security Act (42 U.S.C. 1395w–28(f)), as amended by section 108(a) of the Medicare, Medicaid, and SCHIP Extension Act of 200 7 (Public L aw 110–173) is amended by striking ‘‘2010’’ and inserting ‘‘2011’’. (b) MORATORIUM ON AUTHORITY TO DESIGNATE O THER PLANS AS SPECIALIZED MA PLANS.—During the period beginning on January 1, 2010, and ending on December 31, 2010, the Secretary of Health and Human Services may not exercise the authority Timep e r i od.42USC1395w– 21 n o t e. 42 USC 1395w–22 note. 42 USC 1395w–22 note.
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