[Pages S13273-S13274]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 3240. Mr. ROCKEFELLER (for himself, Mr. Lieberman, Mr. Whitehouse, 
and Mr. Bingaman) submitted an amendment intended to be proposed to 
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr. 
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal 
Revenue Code of 1986 to modify the first-time homebuyers credit in the 
case of members of the Armed Forces and certain other Federal 
employees, and for other purposes; which was ordered to lie on the 
table; as follows:

       On page 1053, between lines 2 and 3, insert the following:

     SEC. 3403A. IMPROVEMENTS TO THE INDEPENDENT MEDICARE ADVISORY 
                   BOARD.

       Section 1899A of the Social Security Act, as added by 
     section 3403, is amended--
       (1) in subsection (c)--
       (A) in paragraph (2)(A), by striking clause (iii) and 
     inserting the following new clause:
       ``(iii) As appropriate, the proposal may include 
     recommendations to adjust payments with respect to all 
     providers of services (as defined in section 1861(u)) and 
     suppliers (as defined in section 1861(d)).'';
       (B) in paragraph (3)(A)(ii)--
       (i) in subclause (I), by inserting ``or'' at the end;
       (ii) in subclause (II), by striking ``; or'' at the end and 
     inserting a period; and
       (iii) by striking subclause (III);
       (C) in paragraph (7)(C), by striking clause (i) and 
     inserting the following new clause:
       ``(i) in the case of implementation year 2015 or any 
     subsequent implementation year, 1.5 percent; and''; and
       (D) by striking paragraph (8);
       (2) in subsection (e), by striking ``August 15'' each place 
     it appears and inserting ``June 1'';
       (3) in subsection (f)(3)(B), by striking ``or advisory 
     reports to Congress'' and inserting ``, advisory reports, or 
     other reports'';
       (4) by redesignating subsections (g) through (m) as 
     subsections (i) through (o), respectively; and
       (5) by adding at the end the following new subsections:
       ``(g) Proposals in Non-Determination Years.--
       ``(1) In general.--In any proposal year in which the Board 
     is not required to transmit a proposal to the President by 
     reason of the application of subclause (I) or (II) of 
     subsection (c)(3)(A)(ii), the Board shall transmit a proposal 
     under this section to the President on January 15 of the 
     year. Except as provided in paragraph (2), such a proposal 
     shall be treated as a proposal under this section and all of 
     the provisions of this section with respect to proposals, 
     including the requirements under paragraphs (2) and (4) of 
     subsection (c) and the required Congressional consideration 
     under subsection (d), shall apply to the proposal.
       ``(2) Exceptions.--The following rules shall apply to a 
     proposal transmitted pursuant to paragraph (1):

[[Page S13274]]

       ``(A) Recommendations for achieving target.--The 
     requirement under subsection (c)(2)(A)(i) shall not apply.
       ``(B) Required information.--The proposal shall not 
     include--
       ``(i) recommendations described in subsection (c)(2)(A)(i), 
     pursuant to subsection (c)(3)(B)(i); or
       ``(ii) an actuarial opinion by the Chief Actuary of the 
     Centers for Medicare & Medicaid Services certifying that the 
     proposal meets the requirements of subsection (c)(2)(A)(i), 
     pursuant to subsection (c)(3)(B)(iii);
       ``(C) Contingent secretarial proposal.--The Secretary shall 
     not submit a proposal if the Board fails to submit a proposal 
     pursuant to subsection (c)(5).
       ``(D) Congressional consideration.--
       ``(i) Subparagraphs (A) and (B) of subsection (d)(3) shall 
     be applied by substituting `subsection (c)(2)(C)' for 
     `subparagraphs (A)(i) and (C) of subsection (c)(2)'.
       ``(ii) Subparagraphs (D) and (E) of subsection (d)(3) and 
     subsection (d)(4)(B)(v) shall be applied by requiring a 
     simple majority rather than three-fifths of the Members duly 
     chosen and sworn.
       ``(iii) Subsection (d)(4)(B)(iv) shall not apply.
       ``(iv) Subsection (d)(4)(C)(v)(II) shall be applied by 
     substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i) 
     and (C) of subsection (c)(2)'.
       ``(v) Subsection (d)(4)(E)(iv)(II) shall be applied by 
     substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i) 
     and (C) of subsection (c)(2)'.
       ``(E) Secretarial implementation.--Subsection (e) shall not 
     apply and the Secretary shall not implement the 
     recommendations contained in the proposal unless the 
     Secretary otherwise has the authority to implement such 
     recommendations.
       ``(h) Annual Report With Recommendations With Respect to 
     the Private Sector.--
       ``(1) In general.--Not later than July 1, 2014, and January 
     15, 2015, and annually thereafter, the Board shall submit to 
     Congress, the Secretary, and the Medicaid and CHIP Payment 
     and Access Commission a report that includes recommendations 
     on--
       ``(A) requirements under the program under this title (or 
     requirements included in the proposal submitted under this 
     section in the year); and
       ``(B) in the case of any report submitted in a year after a 
     determination year (beginning with determination year 2017) 
     in which the Chief Actuary of the Centers for Medicare & 
     Medicaid Services has made a determination described in 
     subclause (I) or (II) of subsection (c)(3)(A)(ii), other 
     requirements determined appropriate by the Board;

     that should be included in the requirements established under 
     section 1311(c) of the Patient Protection and Affordable Care 
     Act for a health plan to be certified as a qualified health 
     plan, such as requirements that improve the health care 
     delivery system and health outcomes (including by promoting 
     integrated care, care coordination, prevention and wellness, 
     and quality and efficiency), decrease health care spending, 
     and other appropriate improvements
       ``(2) Incorporation into certification requirements.--
       ``(A) In general.--The Secretary shall review the 
     recommendations contained in the report submitted to the 
     Secretary by the Board under paragraph (1). The Secretary 
     may, if determined appropriate, incorporate such 
     recommendations into the requirements for certification under 
     such section 1311(c).
       ``(B) Report to congress.--Not later than December 31, 
     2014, and June 15, 2015, and annually thereafter, the 
     Secretary shall submit to Congress a report on the 
     application of subparagraph (A). Such report shall include, 
     with respect to each recommendation contained in a report 
     submitted by the Board in that year, a description of whether 
     or not the Secretary incorporated the recommendation into the 
     requirements for certification under such section 1311(c), 
     and if not, the reasons why.
       ``(3) MACPAC.--The Medicaid and CHIP Payment and Access 
     Commission shall--
       ``(A) review whether or not recommendations contained in a 
     report submitted to the Commission by the Board under 
     paragraph (1) would improve the Medicaid program under title 
     XIX and the Children's Health Insurance Program under title 
     XXI if implemented under such programs; and
       ``(B) include in the Commission's annual report to Congress 
     the results of such review.''.
                                 ______