To amend title XVIII to reform the Medicare Advantage program.

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 3467 Introduced in House (IH)] <DOC> 119th CONGRESS 1st Session H. R. 3467 To amend title XVIII to reform the Medicare Advantage program. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES May 15, 2025 Mr. Schweikert introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend title XVIII to reform the Medicare Advantage program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. REFORMING MEDICARE ADVANTAGE. (a) Requirement To Use Capitated Payments.--Section 1852 of the Social Security Act (42 U.S.C. 1395w-22) is amended by adding at the end the following new subsection: ``(o) Requirement To Use Capitated Payments.-- ``(1) In general.--Subject to paragraph (2) and section 1853(p), for plan years beginning on or after January 1, 2028, a Medicare Advantage plan may only pay for benefits furnished under such plan on a capitated basis. ``(2) Exceptions.--Paragraph (1) shall not apply in the case of the following MA plans for a plan year: ``(A) An MA plan that was made available in such area during the preceding plan year, except that the only individuals eligible to enroll in such plan shall be individuals who were enrolled in such plan during such preceding plan year. ``(B) A specialized MA plan for special needs individuals.''. (b) Payment Modifications.-- (1) Reducing blended benchmark.--Section 1853(j)(1)(A) of the Social Security Act (42 U.S.C. 1395w-23(j)(1)(A)) is amended by inserting ``(or, beginning with 2028, 75 perce