Bill > HR2610

This bill addresses a technical issue in Medicare Advantage (MA) payment calculations related to wage index reclassification, specifically focusing on local areas experiencing significant increases in hospital wage indexes. The legislation provides a method for adjusting the national per capita MA growth percentage for payment areas with weighted average hospital wage indexes that increase by more than 20% in a given year. For the years 2026 and beyond, the bill allows the Secretary of Health and Human Services to increase payment rates for these areas by calculating a specific percentage point adjustment based on the wage index increase and the proportion of total Medicare payments made to hospitals in that area. The adjustment is designed to be "benchmark neutral," meaning it should not fundamentally change the overall Medicare Advantage payment structure. Additionally, the bill requires more transparency by mandating that the total payments to area hospitals be computed and published separately for Medicare Part A and Part B. These changes aim to more accurately reflect local healthcare costs and prevent potential underpayment in areas experiencing rapid wage growth, thereby protecting healthcare options for seniors enrolled in Medicare Advantage plans.

Budget and Finance

https://www.congress.gov/bill/119th-congress/house-bill/2610/all-info